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

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.

Authors+Show Affiliations

Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17178938

Citation

Poetker, David M., et al. "Ofloxacin Otic Drops Vs Neomycin-polymyxin B Otic Drops as Prophylaxis Against Early Postoperative Tympanostomy Tube Otorrhea." Archives of Otolaryngology--head & Neck Surgery, vol. 132, no. 12, 2006, pp. 1294-8.
Poetker DM, Lindstrom DR, Patel NJ, et al. Ofloxacin otic drops vs neomycin-polymyxin B otic drops as prophylaxis against early postoperative tympanostomy tube otorrhea. Arch Otolaryngol Head Neck Surg. 2006;132(12):1294-8.
Poetker, D. M., Lindstrom, D. R., Patel, N. J., Conley, S. F., Flanary, V. A., Link, T. R., & Kerschner, J. E. (2006). Ofloxacin otic drops vs neomycin-polymyxin B otic drops as prophylaxis against early postoperative tympanostomy tube otorrhea. Archives of Otolaryngology--head & Neck Surgery, 132(12), pp. 1294-8.
Poetker DM, et al. Ofloxacin Otic Drops Vs Neomycin-polymyxin B Otic Drops as Prophylaxis Against Early Postoperative Tympanostomy Tube Otorrhea. Arch Otolaryngol Head Neck Surg. 2006;132(12):1294-8. PubMed PMID: 17178938.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ofloxacin otic drops vs neomycin-polymyxin B otic drops as prophylaxis against early postoperative tympanostomy tube otorrhea. AU - Poetker,David M, AU - Lindstrom,D Richard, AU - Patel,Nalin J, AU - Conley,Stephen F, AU - Flanary,Valerie A, AU - Link,T Roxanne, AU - Kerschner,Joseph E, PY - 2006/12/21/pubmed PY - 2007/1/26/medline PY - 2006/12/21/entrez SP - 1294 EP - 8 JF - Archives of otolaryngology--head & neck surgery JO - Arch. Otolaryngol. Head Neck Surg. VL - 132 IS - 12 N2 - 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. SN - 0886-4470 UR - https://www.unboundmedicine.com/medline/citation/17178938/Ofloxacin_otic_drops_vs_neomycin_polymyxin_B_otic_drops_as_prophylaxis_against_early_postoperative_tympanostomy_tube_otorrhea_ L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/archotol.132.12.1294 DB - PRIME DP - Unbound Medicine ER -