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Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media

Year 2002, Volume: 9 Issue: 2, 106 - 111, 12.03.2002

Abstract

Objectives: To evaluate the efficacy of topical ciprofloxacin and tobramycin with and vvithout topical dexamethasone in the treatment of chronic suppurative otitis media vvithout cholesteatoma.Patients and Methods: The study included 103 ears of 80 patients 49 males, 31 females; mean age 31 years; range 18 to 60 years with chronic suppurative otitis media vvithout cholesteatoma. The patients were random- ly divided into four groups to receive topical applications of either ciprofloxacin and tobramycin alone, or in combi­ nation with dexamethasone. Cultures were obtained from the ears preoperatively and 24 hours after treatment.Rtesults: Aerobic bacteria were isolated in 94.1% of patients before the treatment, the most common being Pseudomonas aeruginosa 38.9% . With dexamethasone, the clinical response for ciprofloxacin and tobramycin increased from 80% to 90% and from 70% to 75%, respec- tively, but this improvement was not significant p>0.03 .Addition of dexamethasone to ciprofloxacin decreased the recovery period from 14 days to seven days, vvhereas no change 7 days was observed with tobramycin.Conclusion: The efficacy of ciprofloxacin and tobramycin were similar in the treatment of chronic sup­ purative otitis media. Addition of dexamethasone to ciprofloxacin decreased the treatment period.

References

  • Fradis M, Brodsky A, Ben-David J, Srugo I, Larboni J, Podoshin L. Chronic otitis media treated topically with ciprofloxacin or tobramycin. Arch Otolaryngol Head Neck Surg 1997;123:1057-60.
  • Kenna MA, Bluestone CD. Microbiology of chronic suppurative otitis media in children. Pediatr Infect Dis 1986;5:223-5.
  • Erkan M, Aslan T, Sevük E, Güney E. Bacteriology of c h ronic suppurative otitis media. Ann Otol Rhinol Laryngol 1994;103:771-4.
  • Esposito S, Noviello S, D’Errico G, Montanaro C. Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media. Arch Otolaryngol Head Neck Surg 1992;118:842-4.
  • Fliss DM, Dagan R, Meidan N, Leiberman A. Aerobic bacteriology of chronic suppurative otitis media with- out cholesteatoma in children. Ann Otol Rhinol Laryngol 1992;101:866-9.
  • Erkan M, Cüreoğlu S, Erhan E, Çankaya H. Çocuklar- da kronik süpüratif otitis medianın akut safhasında to- pikal siprofloksasin kullanımı. KBB Bafl Boyun Cerra- hisi Dergisi 1994;2:13-5.
  • Matz GJ. Clinical perspectives on ototoxic drugs. Ann Otol Rhinol Laryngol Suppl 1990;148:39-41.
  • Altuntafl A, Aslan A, Ünal A, Eren N, Titiz A, Nalça Y. Kronik süpüratif otitis media’da izole edilen mikroor- ganizmaların siprofloksasin ve ofloxacine duyarlılıkla- rı. KBB Bafl Boyun Cerrahisi Dergisi 1995;3:102-4.
  • Dohar JE, Kenna MA, Wadowsky RM. Therapeutic implications in the treatment of aural Pseudomonas infections based on in vitro susceptibility patterns. Arch Otolaryngol Head Neck Surg 1995;121:1022-5.
  • P a p a s t a v ros T, Giamarellou H, Varlejides S. Pre o p e r a t i v e therapeutic considerations in chronic suppurative otitis media. Laryngoscope 1989;99(6 Pt 1):655-9.
  • Tutkun A, Ozagar A, Koç A, Batman C, Üneri C, fiehitoğlu MA. Treatment of chronic ear disease. Topical ciprofloxacin vs topical gentamicin. Arc h Otolaryngol Head Neck Surg 1995;121:1414-6.
  • Force RW, Hart MC, Plummer SA, Powell DA, Nahata MC. Topical ciprofloxacin for otorrhea after tympanos- tomy tube placement. Arch Otolaryngol Head Neck Surg 1995;121:880-4.
  • Brownlee RE, Hulka GF, Prazma J, Pillsbury HC 3rd. Ciprofloxacin. Use as a topical otic preparation. Arch Otolaryngol Head Neck Surg 1992;118:392-6.
  • Dohar JE, Garner ET, Nielsen RW, Biel MA, Seidlin M. Topical ofloxacin treatment of otorrhea in children with tympanostomy tubes. Arch Otolaryngol Head Neck S u rg 1999;125:537-45.
  • Piccirillo JF, Parnes SM. Ciprofloxacin for the treat- ment of chronic ear disease. Laryngoscope 1989;99: 510-3.
  • Esposito S, D’Errico G, Montanaro C. Topical and oral treatment of chronic otitis media with ciprofloxacin. A preliminary study. Arch Otolaryngol Head Neck Surg 1990;116:557-9.
  • Nelson JD. Chronic suppurative otitis media. Pediatr Infect Dis J 1988;7:446-8.
  • Lundy LB, Graham MD. Ototoxicity and ototopical medications: a survey of otolaryngologists. Am J Otol 1993;14:141-6.
  • Indudharan R, Haq JA, Aiyar S. Antibiotics in chronic suppurative otitis media: a bacteriologic study. Ann Otol Rhinol Laryngol 1999;108:440-5.
  • Brook I, Burke P. The management of acute, serous and chronic otitis media: the role of anaerobic bacteria. J Hosp Infect 1992;22 Suppl A:75-87.
  • Kenna MA, Bluestone CD. Microbiology of chronic suppurative otitis media in children. Pediatr Infect Dis 1986;5:223-5.
  • Nakagawa T, Yadohisa O, Komune S, Uemura T. A 16- year survey of changes in bacterial isolates associated with chronic suppurative otitis media. Eur Arc h Otorhinolaryngol 1994;251 Suppl 1:S27-32.
  • Jahn AF. Chronic otitis media: diagnosis and treat- ment. Med Clin North Am 1991;75:1277-91.
  • Dohar JE, Alper CM, Rose EA, Doyle WJ, Casselbrant ML, Kenna MA, et al. Treatment of chronic suppura- tive otitis media with topical ciprofloxacin. Ann Otol Rhinol Laryngol 1998;107(10 Pt 1):865-71.
  • Koestner JA. Ciprofloxacin: a new fluoroquinolone. Am J Med Sci 1989;297:128-31.
  • İkiz AÖ, Lebe ME, Güneri EA, Erdağ TK, fierbetçioğlu MB. Kronik otitis medianın akut alevlenmelerinde topikal siprofloksasinin etkinlik ve güvenirliliği. KBB İhtisas Dergisi 2001;8:119-23.
  • Browning GG, Gatehouse S, Calder IT. Medical man- agement of active chronic otitis media: a controlled study. J Laryngol Otol 1988;102:491-5.
  • Alper CM, Dohar JE, Gulhan M, Ozunlu A, Bagger- Sjobak D, Hebda PA, et al. Treatment of chronic sup- purative otitis media with topical tobramycin and dex- amethasone. Arch Otolaryngol Head Neck Surg 2000; 126:165-73.

Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı

Year 2002, Volume: 9 Issue: 2, 106 - 111, 12.03.2002

Abstract

Amaç: Kolesteatomasız kronik süpüratif otitis media KSOM tedavisinde topikal tobramisin ve siprofloksasinkullanımı ile topikal deksametazon kombinasyonununkulak akıntısı üzerine etkilerini arafltırmak. Has talar ve Yöntemler: Kolesteatomasız kronik süpüratifotitis media tanısı alan 80 hastanın 103 kulağı incelendi. Hastalar, rastgele 20’flerli dört gruba ayrıldı ve sırasıyla grup I’e topikalsiprofloksasin, grup II’ye topikal tobramisin, grup III’e topikalsiprofloksasin ve deksametazon, grup IV’e topikal tobramisin ve deksametazon uygulandı. Tedavi öncesi ve tedaviden24 saat sonra kulaklardan alınan kültürler değerlendirildi.Bul g u l a r : Tedavi öncesinde kültürlerin %94.1’inde aerobikbakteri üredi. En sık Pseudomonas aeruginosa % 3 8 . 9 izole edildi. Grup I’de %80, grup II’de %70 tam iyileflmegerçekleflti. Deksametazon ile grup III’de bafları oranı%90’a, grup IV’de %75’e yükseldi; ancak bu fark anlamlıbulunmadı p>0.03 . Siprofloksasin tedavisine deksametazon eklenmesi ile tedavi süresi 14 günden yedi güne düfltü; tobramisine deksametazon eklenmesi tedavi süresini 7gün değifltirmedi.Sonu ç : Siprofloksasin ile tobramisinin KSOM’da tedavi etkinliği açısından benzer özelliklere sahip olduğu, tedaviyesteroid eklenmesi ile siprofloksasin kullanılan hastalardaiyileflme süresinin kısaldığı saptandı

References

  • Fradis M, Brodsky A, Ben-David J, Srugo I, Larboni J, Podoshin L. Chronic otitis media treated topically with ciprofloxacin or tobramycin. Arch Otolaryngol Head Neck Surg 1997;123:1057-60.
  • Kenna MA, Bluestone CD. Microbiology of chronic suppurative otitis media in children. Pediatr Infect Dis 1986;5:223-5.
  • Erkan M, Aslan T, Sevük E, Güney E. Bacteriology of c h ronic suppurative otitis media. Ann Otol Rhinol Laryngol 1994;103:771-4.
  • Esposito S, Noviello S, D’Errico G, Montanaro C. Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media. Arch Otolaryngol Head Neck Surg 1992;118:842-4.
  • Fliss DM, Dagan R, Meidan N, Leiberman A. Aerobic bacteriology of chronic suppurative otitis media with- out cholesteatoma in children. Ann Otol Rhinol Laryngol 1992;101:866-9.
  • Erkan M, Cüreoğlu S, Erhan E, Çankaya H. Çocuklar- da kronik süpüratif otitis medianın akut safhasında to- pikal siprofloksasin kullanımı. KBB Bafl Boyun Cerra- hisi Dergisi 1994;2:13-5.
  • Matz GJ. Clinical perspectives on ototoxic drugs. Ann Otol Rhinol Laryngol Suppl 1990;148:39-41.
  • Altuntafl A, Aslan A, Ünal A, Eren N, Titiz A, Nalça Y. Kronik süpüratif otitis media’da izole edilen mikroor- ganizmaların siprofloksasin ve ofloxacine duyarlılıkla- rı. KBB Bafl Boyun Cerrahisi Dergisi 1995;3:102-4.
  • Dohar JE, Kenna MA, Wadowsky RM. Therapeutic implications in the treatment of aural Pseudomonas infections based on in vitro susceptibility patterns. Arch Otolaryngol Head Neck Surg 1995;121:1022-5.
  • P a p a s t a v ros T, Giamarellou H, Varlejides S. Pre o p e r a t i v e therapeutic considerations in chronic suppurative otitis media. Laryngoscope 1989;99(6 Pt 1):655-9.
  • Tutkun A, Ozagar A, Koç A, Batman C, Üneri C, fiehitoğlu MA. Treatment of chronic ear disease. Topical ciprofloxacin vs topical gentamicin. Arc h Otolaryngol Head Neck Surg 1995;121:1414-6.
  • Force RW, Hart MC, Plummer SA, Powell DA, Nahata MC. Topical ciprofloxacin for otorrhea after tympanos- tomy tube placement. Arch Otolaryngol Head Neck Surg 1995;121:880-4.
  • Brownlee RE, Hulka GF, Prazma J, Pillsbury HC 3rd. Ciprofloxacin. Use as a topical otic preparation. Arch Otolaryngol Head Neck Surg 1992;118:392-6.
  • Dohar JE, Garner ET, Nielsen RW, Biel MA, Seidlin M. Topical ofloxacin treatment of otorrhea in children with tympanostomy tubes. Arch Otolaryngol Head Neck S u rg 1999;125:537-45.
  • Piccirillo JF, Parnes SM. Ciprofloxacin for the treat- ment of chronic ear disease. Laryngoscope 1989;99: 510-3.
  • Esposito S, D’Errico G, Montanaro C. Topical and oral treatment of chronic otitis media with ciprofloxacin. A preliminary study. Arch Otolaryngol Head Neck Surg 1990;116:557-9.
  • Nelson JD. Chronic suppurative otitis media. Pediatr Infect Dis J 1988;7:446-8.
  • Lundy LB, Graham MD. Ototoxicity and ototopical medications: a survey of otolaryngologists. Am J Otol 1993;14:141-6.
  • Indudharan R, Haq JA, Aiyar S. Antibiotics in chronic suppurative otitis media: a bacteriologic study. Ann Otol Rhinol Laryngol 1999;108:440-5.
  • Brook I, Burke P. The management of acute, serous and chronic otitis media: the role of anaerobic bacteria. J Hosp Infect 1992;22 Suppl A:75-87.
  • Kenna MA, Bluestone CD. Microbiology of chronic suppurative otitis media in children. Pediatr Infect Dis 1986;5:223-5.
  • Nakagawa T, Yadohisa O, Komune S, Uemura T. A 16- year survey of changes in bacterial isolates associated with chronic suppurative otitis media. Eur Arc h Otorhinolaryngol 1994;251 Suppl 1:S27-32.
  • Jahn AF. Chronic otitis media: diagnosis and treat- ment. Med Clin North Am 1991;75:1277-91.
  • Dohar JE, Alper CM, Rose EA, Doyle WJ, Casselbrant ML, Kenna MA, et al. Treatment of chronic suppura- tive otitis media with topical ciprofloxacin. Ann Otol Rhinol Laryngol 1998;107(10 Pt 1):865-71.
  • Koestner JA. Ciprofloxacin: a new fluoroquinolone. Am J Med Sci 1989;297:128-31.
  • İkiz AÖ, Lebe ME, Güneri EA, Erdağ TK, fierbetçioğlu MB. Kronik otitis medianın akut alevlenmelerinde topikal siprofloksasinin etkinlik ve güvenirliliği. KBB İhtisas Dergisi 2001;8:119-23.
  • Browning GG, Gatehouse S, Calder IT. Medical man- agement of active chronic otitis media: a controlled study. J Laryngol Otol 1988;102:491-5.
  • Alper CM, Dohar JE, Gulhan M, Ozunlu A, Bagger- Sjobak D, Hebda PA, et al. Treatment of chronic sup- purative otitis media with topical tobramycin and dex- amethasone. Arch Otolaryngol Head Neck Surg 2000; 126:165-73.
There are 28 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

İrfan Kaygusuz This is me

Turgut Karlıdağ This is me

Üzeyir Gök This is me

Şinasi Yalçın This is me

Erol Keleş This is me

Erhan Demirbağ This is me

Türkkan Öztürk Kaygusuz This is me

Publication Date March 12, 2002
Published in Issue Year 2002 Volume: 9 Issue: 2

Cite

APA Kaygusuz, İ., Karlıdağ, T., Gök, Ü., Yalçın, Ş., et al. (2002). Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı. The Turkish Journal of Ear Nose and Throat, 9(2), 106-111.
AMA Kaygusuz İ, Karlıdağ T, Gök Ü, Yalçın Ş, Keleş E, Demirbağ E, Öztürk Kaygusuz T. Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı. Tr-ENT. March 2002;9(2):106-111.
Chicago Kaygusuz, İrfan, Turgut Karlıdağ, Üzeyir Gök, Şinasi Yalçın, Erol Keleş, Erhan Demirbağ, and Türkkan Öztürk Kaygusuz. “Kronik süpüratif Otitis Media Tedavisinde Topikal Siprofloksasin Ve Tobramisinin Deksametazon Ile kullanımı”. The Turkish Journal of Ear Nose and Throat 9, no. 2 (March 2002): 106-11.
EndNote Kaygusuz İ, Karlıdağ T, Gök Ü, Yalçın Ş, Keleş E, Demirbağ E, Öztürk Kaygusuz T (March 1, 2002) Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı. The Turkish Journal of Ear Nose and Throat 9 2 106–111.
IEEE İ. Kaygusuz, T. Karlıdağ, Ü. Gök, Ş. Yalçın, E. Keleş, E. Demirbağ, and T. Öztürk Kaygusuz, “Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı”, Tr-ENT, vol. 9, no. 2, pp. 106–111, 2002.
ISNAD Kaygusuz, İrfan et al. “Kronik süpüratif Otitis Media Tedavisinde Topikal Siprofloksasin Ve Tobramisinin Deksametazon Ile kullanımı”. The Turkish Journal of Ear Nose and Throat 9/2 (March 2002), 106-111.
JAMA Kaygusuz İ, Karlıdağ T, Gök Ü, Yalçın Ş, Keleş E, Demirbağ E, Öztürk Kaygusuz T. Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı. Tr-ENT. 2002;9:106–111.
MLA Kaygusuz, İrfan et al. “Kronik süpüratif Otitis Media Tedavisinde Topikal Siprofloksasin Ve Tobramisinin Deksametazon Ile kullanımı”. The Turkish Journal of Ear Nose and Throat, vol. 9, no. 2, 2002, pp. 106-11.
Vancouver Kaygusuz İ, Karlıdağ T, Gök Ü, Yalçın Ş, Keleş E, Demirbağ E, Öztürk Kaygusuz T. Kronik süpüratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanımı. Tr-ENT. 2002;9(2):106-11.