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

Yıl 2002, Cilt: 9 Sayı: 2, 106 - 111, 12.03.2002

İrfan Kaygusuz Turgut Karlıdağ Üzeyir Gök Şinasi Yalçın Erol Keleş Erhan Demirbağ Türkkan Öztürk Kaygusuz

Öz

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.

Anahtar Kelimeler

Administration, topical, ciprofloxacin/therapeutic use, dexamethasone/therapeutic use, glucocorticoids, otitis media, suppurative/microbiology/drug therapy, Pseudomonas aeruginosa, tobramycin/therapeutic use

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

Öz

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

Anahtar Kelimeler

Uygulama, topikal, siprofloksasin/terapötikkullanım, deksametason/terapötik kullanım, glukokortikoid, topikal, otitis media, süpüratif/mikrobiyoloji/ilaç tedavisi, Pseudomonas aeruginosa, tobramisin//terapötik kullanım

Kaynakça

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