title: Preoperative therapeutic considerations in chronic suppurative otitis media.
abstract: The present randomized, prospective study of 119 cases of chronic suppurative otitis media compares the effectiveness of inexpensive, atoxic, nonallergenic disinfectants applied locally, to that of a number of occasionally toxic antimicrobial chemotherapeutic agents, administered systemically. Systemic treatment resulted in a cure rate of 53.5% (SEp = 5.9%) while ototopical treatment resulted in a 39.5% cure rate (SEp = 7%). Eradication of pathogens or colonization by a nonpathogen occurred in 50.7% (SEp = 5.9%) with systemic treatment, and in 39.5% (SEp = 7%) with ototopical treatment. Bacteriological modification was 2.5 times more frequent with systemic treatment than with ototopical treatment. No recurrences were noted with ototopical treatment, while 13% to 36% recurrence rates were noted in various subgroups of cases treated systemically. Cure rates achieved with particular drug regimens (administration based on sensitivity tests in vitro) were: Azactam 25% (5%-57% confidence limits), sulfamethoxazole plus trimethoprim 58.6% (38%-76%), ciprofloxacin 87.5% (47%-99%), ciprofloxacin plus metronidazole 90% (55%-99%). Cure rates with other drugs were inconclusive because of the limited number of observations.
authors.affiliation: Department of Otolaryngology of Evangelismos General Hospital, University of Athens, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Papastavros
authors.forename: H
authors.initials: H
authors.lastname: Giamarellou
authors.forename: S
authors.initials: S
authors.lastname: Varlejides
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000188:drug therapy*; D010035:Otitis Media, Suppurative / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D011446:Prospective Studies; D011897:Random Allocation; D012008:Recurrence
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local