Faculty Collaboration Database

Ofloxacin otic drops vs neomycin-polymyxin B otic drops as prophylaxis against early postoperative tympanostomy tube otorrhea. Arch Otolaryngol Head Neck Surg 2006 Dec;132(12):1294-8

Date

12/21/2006

Pubmed ID

17178938

DOI

10.1001/archotol.132.12.1294

Scopus ID

2-s2.0-33845629915 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

OBJECTIVES: To evaluate the incidence of tympanostomy tube (TT) sequelae, tube otorrhea, and tube obstruction immediately postoperatively in patients receiving TT for otitis media and to compare patients receiving postoperative otic drops with controls.

DESIGN: Blinded randomized control trial.

SETTING: A tertiary pediatric otolaryngology practice.

SUBJECTS: The study population comprised 306 patients undergoing TT placement.

INTERVENTIONS: The 306 patients were enrolled into the following 3 groups: (1) those receiving no postoperative otic drop prophylaxis (control group), (2) those receiving ofloxacin otic drops (FLOX group), and (3) those receiving neomycin sulfate-polymyxin B sulfate-hydrocortisone otic drops (COS group).

RESULTS: Overall otorrhea rates postoperatively were 14.9% for the control group, 8.1% for the FLOX group, and 5.5% for the COS group. When controlling for disease severity, the rate of otorrhea was significantly higher for the control group than for both the FLOX (P = .04) and COS (P = .01) groups. Nonpatent, plugged, tube rates were added to otorrhea rates for a TT failure analysis postoperatively. The control group demonstrated a significantly greater failure rate (29.9%) than both the FLOX (12.1%) and COS (7.7%) groups. The only differences between the patients in the 2 groups receiving drops were that ofloxacin was more well liked by patients (P = .04) and caused less pain (P = .004).

CONCLUSIONS: Nonpatency and otorrhea are the most frequent sequelae immediately following TT placement. Few studies have compared different treatment regimens in a randomized controlled trial. These results demonstrate that otic drops clearly provide benefit postoperatively in preventing TT plugging and otorrhea but primarily in patients who have middle ear fluid at the time of TT placement. In addition, consideration of drop choice should be based on patient tolerance and medication safety profiles.

Author List

Poetker DM, Lindstrom DR, Patel NJ, Conley SF, Flanary VA, Link TR, Kerschner JE

Authors

Valerie A. Flanary MD Director, Professor in the Otolaryngology department at Medical College of Wisconsin
Joseph E. Kerschner MD Provost, Executive Vice President, Dean, Professor in the School of Medicine Administration department at Medical College of Wisconsin
T Roxanne Link NP APP Outpatient in the Otolaryngology department at Medical College of Wisconsin
David M. Poetker MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Topical
Anti-Bacterial Agents
Cerebrospinal Fluid Otorrhea
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Male
Middle Ear Ventilation
Neomycin
Ofloxacin
Otitis Media
Polymyxin B
Postoperative Complications
Retrospective Studies
Time Factors
Treatment Outcome