Why are ototopical aminoglycosides still first-line therapy for chronic suppurative otitis media?

This systematic review aimed to establish that quinolones are as effective as aminoglycosides when used to treat chronic suppurative otitis media | The Journal of Laryngology & Otology

pills

The review included good quality, randomised, controlled trials on human subjects, published in English, that compared topical aminoglycosides with topical quinolones for the treatment of chronic suppurative otitis media.

Nine trials met the criteria. Two studies showed a higher clinical cure rate in the quinolone group (93 per cent vs 71 per cent, p = 0.04, and 76 per cent vs 52 per cent, p = 0.009). Four studies showed no statistically significant difference in clinical outcome. A significant difference in microbiological clearance in favour of quinolones was shown in two studies (88 per cent vs 30 per cent, p < 0.001, and 88 per cent vs 30 per cent, p < 0.001).

Topical quinolones do not carry the same risk of ototoxicity as aminoglycosides. Furthermore, they are equal or more effective in treating chronic suppurative otitis media and when used as prophylaxis post-myringotomy. Topical quinolones should be considered a first-line treatment for these patients.

Full reference: Harris, A.S. et al. (2017) Why are ototopical aminoglycosides still first-line therapy for chronic suppurative otitis media? A systematic review and discussion of aminoglycosides versus quinolones. The Journal of Laryngology & Otology. Vol. 130, (no. 01) pp. 2-7

Advertisements

Treatment Protocol for Management of Bacterial and Fungal Malignant External Otitis

High rates of negative microbiologic test results highlight the potential role of empiric antimicrobial agents in management of malignant otitis externa (MOE) | Annals of Otology, Rhinology & Laryngology

Aims: This study investigates the clinical presentation, laboratory findings, and response to empiric treatment in a large group of patients admitted to a tertiary academic hospital in Tehran, Iran.

Methods and Materials: We recruited 224 patients diagnosed with MOE in a prospective observation from 2009 through 2015. All patients received a 2-agent antibacterial regimen at baseline (phase I). Patients with no improvement within 10 days and/or nonresponders to a second course of antibacterials were switched to antifungals (phase II). Response to treatment was observed and documented in both groups.

Results: All patients had physical symptoms for more than 12 weeks before admission. In total, 127 patients responded well to antibacterials. Eighty-seven out of 97 patients who were switched to antifungals had complete response to treatment; patients in the latter group had significantly higher A1C levels at baseline.

Conclusion: Our findings provide evidence to develop clinical guidelines that accelerate diagnosis and treatment of MOE to improve patient outcomes.

Full reference: Hasibi, M. et al. (2017) A Treatment Protocol for Management of Bacterial and Fungal Malignant External Otitis: A Large Cohort in Tehran, Iran. Annals of Otology, Rhinology & Laryngology. 126(7) pp. 561 – 567

Deafness could be treated by virus, say scientists – BBC News

Scientists say they have taken a significant step towards treating some forms of deafness after restoring hearing in animals.

Defects in a baby’s DNA are behind roughly half of cases of hearing loss in early life.

The mouse study, published in Science Translational Medicine, showed a virus could correct the genetic fault and restore some hearing.

Experts said the results could lead to treatments within a decade.

The team in the US and Switzerland focused on the tiny hairs inside the ear, which convert sounds into electrical signals that can be interpreted by the brain.

But mutations in our DNA can leave hairs unable to create the electrical signal – leaving people unable to hear.

via Deafness could be treated by virus, say scientists – BBC News.