Prophylactic antibiotic drops after tympanostomy tube placement.
OBJECTIVE
To evaluate the effectiveness of prophylactic polymyxin B sulfate-neomycin sulfate-hydrocortisone drops in decreasing the incidence of posttympanostomy otorrhea.


METHODS
Prospective randomized controlled study.


METHODS
University referral center.


METHODS
Three hundred patients undergoing tympanostomy tube placement (including those undergoing tonsillectomy, adenoidectomy, or both) were randomized into three groups.


METHODS
The use of polymyxin B-neomycin-hydrocortisone drops. Patients in group 1 received no antibiotic drops; group 2, a single dose intraoperatively, and group 3, an intraoperative dose followed by a 5-day course.


METHODS
Posttympanostomy otorrhea.


RESULTS
A statistically significant decrease was observed in the incidence of posttympanostomy otorrhea between the control (16.4%) and treatment groups (group 2, 8.3%; group 3, 8.1%) (P = .011). A single dose of antibiotics was effective when patients' middle ears were dry or had serous effusions. A 5-day course was indicated for those whose ears had mucoid or purulent contents.


CONCLUSIONS
Antibiotic ear drops are indicated in all patients. A single dose is as effective as a 5-day course, but our data support a longer course in certain subgroups.
Hester
T O
TO
Department of Surgery, University of Kentucky Medical Center, Lexington, USA.
Jones
R O
RO
Archer
S M
SM
Haydon
R C
RC
D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D007223:Infant; D007322:Instillation, Drug; D008876:Middle Ear Ventilation; D009355:Neomycin / Q000627:therapeutic use*; D010033:Otitis Media / Q000601:surgery; D010034:Otitis Media with Effusion / Q000517:prevention & control*; D011112:Polymyxin B / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
D004338:Drug Combinations; D009355:Neomycin; D011112:Polymyxin B; D006854:Hydrocortisone