Topical Ciprofloxacin Is Superior to Topical Saline and Systemic Antibiotics in the Treatment of Tympanostomy Tube Otorrhea in Children: The Results of a Randomized Clinical Trial
Topical Ciprofloxacin Is Superior to Topical Saline and Systemic Antibiotics in the Treatment of Tympanostomy Tube Otorrhea in Children: The Results of a Randomized Clinical Trial
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DOI：
10.1002/lary.21015
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发表时间：
2010-12-01
期刊：
影响因子：
2.6
通讯作者：
Ovesen, Therese
中科院分区：
文献类型：
--
作者：
Heslop, Anders;Lildholdt, Torben;Ovesen, Therese
目的/假设：比较耳鼻喉科儿童通过鼓膜造口管局部或全身抗生素治疗与topical salines.Study设计：随机，双盲，对照patient study.Methods的临床失败率：一个三臂随机临床试验使用局部环丙沙星或口服阿莫西林或局部盐水。主要结果是治疗失败的定义为存在耳炎在至少一只耳朵后7 daystressing.Results：治疗失败率分别为23%和70%，在治疗组与局部环丙沙星和口服阿莫西林，分别。58%的局部用生理盐水治疗的儿童出现治疗失败。因此，与口服阿莫西林和外用生理盐水相比，外用环丙沙星显著减少了治疗失败。从治疗失败中分离出的最常见的细菌一般是链球菌和卡他莫拉菌。结论：局部应用环丙沙星的显著效果可能与中耳局部较高的抗生素浓度有关，而不是机械冲洗和溶解细菌负荷的结果。
Objectives/Hypothesis: To compare the clinical failure rates among children with otorrhea through tympanostomy tubes treated with topical or systemic antibiotics versus topical saline.Study Design: Randomized, double-blind, controlled patient study.Methods: A three-armed randomized clinical trial using topical ciprofloxacin or oral amoxicillin or topical saline. The primary outcome was treatment failure defined as presence of otorrhea in at least one ear after 7 days of treatment.Results: The treatment failure rates were 23% and 70% in the group treated with topical ciprofloxacin and oral amoxicillin, respectively. Treatment failures were seen in 58% of children treated with topical saline. Thus, topical ciprofloxacin significantly reduced treatment failures compared to both oral amoxicillin and topical saline. The most frequent bacteria isolated from treatment failures in general were streptococci and Moraxella catarrhalis.,Conclusions: The significant effect of topical ciprofloxacin is probably related to a higher local concentration of antibiotics in the middle ear rather than the result of mechanical rinsing and dissolution of the bacterial load.