Comparison between the efficacy of topical ciprofloxacin with neomycin in the management of chronic suppurative otitis media

Objective: To compare the efficacy of topical Ciprofloxacin with Neomycin in the management of Chronic Supportive Otitis Media [CSOM]

Study Design: Randomized Clinical Trial [RCT]

Place and Duration of Study: Combined Military Hospital [CMH], Peshawar from Jan 2013 to Dec 2013

Patients and Methods: A total of 186 patients with the diagnosis of chronic suppurative otitis media were included in the study. Patients were randomly allotted to either group I that was treated by topical Ciprofloxacin eardrops [n = 93] or to group II, treated by topical Neomycin eardrops [n = 93]. Outcomes were measured by disappearance of discharge and congestion at follow-up examination. SPSS 16 was used for data analysis .Chi square test was used for analysis and p-values less than 0.05 were considered significant

Results: Topical Ciprofloxacin is more effective in earlier control of congestion and discharge of ear in CSOM; [p value = 0.001 and < 0.005 respectively] as compared to Neomycin

Conclusion: Topical Ciprofloxacin is a better drug for the treatment of CSOM as compared to topical Neomycin

Chronic suppurative otitis media; frequency of pseudomonas aeruginosa in patients and its sensitivity to various antibiotics

To identify the frequency of pseudomonas aeruginosa in patients of chronic suppurative otitis media and it sensitivity to various antibiotics. A descriptive study. The study was carried out from Nov 2002 to may 2003 at Department of ENT, Head and Neck surgery, Combined Military Hospital, Rawalpindi. A total 150 patients with unilateral or bilateral active Chronic Suppurative Otitis Media from the out patients clinic were included in the study. All patients were evaluated through detailed history and through clinical examination. Pus samples were collected from the discharging ear[s] and sent to pathological laboratory of the hospital for culture sensitivity. In this study, 82% cases yielded pure cultures, 15% yielded mixed cultures while 3% yielded no growth. The pure cultures yielded pseudomonas aeruginosa in 52.5% of the cases, Staph. Aureus in 15%, Proteus SPP in 6.5%, klebsiella in 2.6%, E. Coli in 2%, anaerobes in 1.3%, Aspergillus in 1.3% and Candida in 0.6% of the cases. In mixed cultures, pseudomonas was isolated in 7.3% of the cases, Staph. Aureus in 2.6%, proteus in 2%, Klebsiella in 0.6% and E. Coli in 0.6% of the cases. Pseudomonas was sensitive to Gentamicin in 70% of cases, Amikacin 92%, Ciprofloxacin 95%, Ceftazidime 84%, Cephoperazone 82%, Cefipime 84%, Aztreonam 83%, imipenem 98%, Levofloxacin 97%, Augmentin 67% and chloramphenicol in 56% of the cases. Pseudomonas aeruginosa was the most commonly isolated organism followed by staphylococcus aureus. Pseudomonas aeruginosa is increasingly becoming more resistant to the common dugs. This necessitates the early diagnosis and prompt treatment of the disease so as to avoid the complications of CSOM