OBJECTIVES: To compare the effectiveness of ototopical ciprofloxacin (0.3%; CIP) with framycetin (0.5%), gramicidin, dexamethasone (FGD) eardrops (5 drops twice daily for 9 days) together with povidone-iodine (0.5%) ear cleaning as treatments for chronic suppurative otitis media (CSOM) in Aboriginal children. DESIGN AND PARTICIPANTS: Aboriginal community-controlled, community-based, multicentre, double-blind, randomised controlled trial in eight Aboriginal Community Controlled Health Services across northern Australia, involving 147 Aboriginal children with CSOM. MAIN OUTCOME MEASURES: Resolution of otorrhoea (clinical cure), proportion of children with healed perforated tympanic membrane (TM) andimproved hearing, 10-21 days after starting treatment. RESULTS:111 children aged 1-14 years (CIP, 55; FGD, 56) completed treatment. CSOM cures occurred in 64% (CIP, 76.4%; FGD, 51.8%), with a significantly higher rate in the ciprofloxacin group (P = 0.009, absolute difference of 24.6% [95% CI, 15.8%-33.4%]). TM perforation size and the level of hearing impairment did not change. Pseudomonas aeruginosa was the most common bacterial pathogen (in 47.6%), while respiratory pathogens were rare (in 5.7%). CONCLUSIONS: Twice-daily ear cleaning and topical ciprofloxacin is effective at community-level in achieving cure for CSOM. Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment.
RCT Entities:
OBJECTIVES: To compare the effectiveness of ototopical ciprofloxacin (0.3%; CIP) with framycetin (0.5%), gramicidin, dexamethasone (FGD) eardrops (5 drops twice daily for 9 days) together with povidone-iodine (0.5%) ear cleaning as treatments for chronic suppurative otitis media (CSOM) in Aboriginal children. DESIGN AND PARTICIPANTS: Aboriginal community-controlled, community-based, multicentre, double-blind, randomised controlled trial in eight Aboriginal Community Controlled Health Services across northern Australia, involving 147 Aboriginal children with CSOM. MAIN OUTCOME MEASURES: Resolution of otorrhoea (clinical cure), proportion of children with healed perforated tympanic membrane (TM) and improved hearing, 10-21 days after starting treatment. RESULTS: 111 children aged 1-14 years (CIP, 55; FGD, 56) completed treatment. CSOM cures occurred in 64% (CIP, 76.4%; FGD, 51.8%), with a significantly higher rate in the ciprofloxacin group (P = 0.009, absolute difference of 24.6% [95% CI, 15.8%-33.4%]). TM perforation size and the level of hearing impairment did not change. Pseudomonas aeruginosa was the most common bacterial pathogen (in 47.6%), while respiratory pathogens were rare (in 5.7%). CONCLUSIONS: Twice-daily ear cleaning and topical ciprofloxacin is effective at community-level in achieving cure for CSOM. Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment.
Authors: Guillermo L Monroy; Paritosh Pande; Ryan M Nolan; Ryan L Shelton; Ryan G Porter; Michael A Novak; Darold R Spillman; Eric J Chaney; Daniel T McCormick; Stephen A Boppart Journal: J Biomed Opt Date: 2017-12 Impact factor: 3.170
Authors: Rahul Mittal; Christopher V Lisi; Robert Gerring; Jeenu Mittal; Kalai Mathee; Giri Narasimhan; Rajeev K Azad; Qi Yao; M'hamed Grati; Denise Yan; Adrien A Eshraghi; Simon I Angeli; Fred F Telischi; Xue-Zhong Liu Journal: J Med Microbiol Date: 2015-08-05 Impact factor: 2.472
Authors: Julia V Marley; David Atkinson; Carmel Nelson; Tracey Kitaura; Dennis Gray; Sue Metcalf; Richard Murray; Graeme P Maguire Journal: BMC Public Health Date: 2012-03-23 Impact factor: 3.295
Authors: Christopher G Brennan-Jones; Karen Head; Lee-Yee Chong; Martin J Burton; Anne Gm Schilder; Mahmood F Bhutta Journal: Cochrane Database Syst Rev Date: 2020-01-02
Authors: Karen Head; Lee-Yee Chong; Mahmood F Bhutta; Peter S Morris; Shyan Vijayasekaran; Martin J Burton; Anne Gm Schilder; Christopher G Brennan-Jones Journal: Cochrane Database Syst Rev Date: 2020-01-06
Authors: Karen Head; Lee-Yee Chong; Mahmood F Bhutta; Peter S Morris; Shyan Vijayasekaran; Martin J Burton; Anne Gm Schilder; Christopher G Brennan-Jones Journal: Cochrane Database Syst Rev Date: 2020-01-06