title: Ototopical agents in the treatment of the draining ear.
abstract: Otorrhea is the result of several pathologic conditions of the ear, including bacterial, fungal, and viral acute external otitis (AOE), acute otitis media with perforation (AOM), posttympanostomy tube otorrhea (PTTO), and chronic suppurative otitis media (CSOM). The significant differences among these conditions necessitate a thorough knowledge of the pathogenesis of each prior to the selection of a treatment regimen likely to succeed. Consideration must be given to the accelerating process of antimicrobial resistance, rising concern over ototoxicity, and limits on the resources available for healthcare in general. This article reviews the pathophysiology of AOE, AOM, PTTO, and CSOM and proposes treatment options that demonstrate the value of ototopical therapy as the first-line treatment option for AOE, PTTO, and CSOM with consideration given to efficacy as well as cost effectiveness. The growing concern with ototoxicity and resultant recent litigation issues are also discussed.
authors.forename: James C
authors.initials: JC
authors.lastname: Denneny
mesh_terms: D000208:Acute Disease; D000287:Administration, Topical; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D010033:Otitis Media / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D014481:United States
chemical_list: D000890:Anti-Infective Agents