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Eardrops More Effective Than Oral Antibiotics for Tympanostomy-Tube Otorrhea — Physician’s First Watch

Medical News |
February 20, 2014

Eardrops More Effective Than Oral Antibiotics for Tympanostomy-Tube Otorrhea

By Amy Orciari Herman

Eardrops containing antibiotics and hydrocortisone are more effective than oral antibiotics for managing uncomplicated otorrhea in children with tympanostomy tubes, a New England Journal of Medicine study finds.

Some 230 children (aged 1-10 years) in the Netherlands with tympanostomy-tube otorrhea were randomized to hydrocortisone-bacitracin-colistin eardrops for 7 days, oral amoxicillin-clavulanate for 7 days, or initial observation. At 2 weeks, otorrhea persisted in just 5% of children in the eardrop group, versus 44% in the oral antibiotic group and 55% in the observation group. In addition, during 6 months' follow-up, the median number of days of otorrhea was 5, 13.5, and 18, respectively.

In NEJM Journal Watch, pediatrician F. Bruder Stapleton notes: "This combination of agents in eardrops is not currently approved by the FDA. However, a ciprofloxacin and dexamethasone suspension (Ciprodex) has also been shown to be effective for this indication and is FDA approved for use in children aged 6 months and older."

Reader Comments (1)

harold jitschak bueno de mesquita Physician, Family Medicine/General Practice, Jerusalem

Dear Sir /colleague,
I n 1970 I finished my medical studies in Utrecht [ [Holland]
I seem to remember quite well that we were warned for ear drops containing bacitracin,neomycin and such combinations as these may harm the 8th nerve
Did any thing changed in opinions since then?
thanks for a possible answer.

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