gramicidin-a and Otitis-Media-with-Effusion

A prospective randomized controlled study was carried out to investigate the effect of prophylactic antibiotic ear drops used for five days after bilateral grommet insertion. The average improvement in the hearing threshold was significantly better in ears in which there was an effusion (16 dB) compared with no effusion (9 dB). The drops had no significant effect upon grommet function at three months measured by blockage rates, extrusion rates or improvement in pure tone audiometry whether or not there was an effusion. The drops were not therefore cost-effective.

Topics: Adolescent; Adult; Audiometry, Pure-Tone; Auditory Threshold; Child; Child, Preschool; Cost-Benefit Analysis; Dexamethasone; Drug Therapy, Combination; Framycetin; Gramicidin; Humans; Infant; Instillation, Drug; Middle Ear Ventilation; Otitis Media with Effusion; Postoperative Period; Prospective Studies; Reoperation

To compare the efficacy of 5% NaHCO3, 3% H2O2, Sofradex (dexamethasone sodium metasulphobenzoate 0.05%, framycetin sulphate 0.5%, gramicidin 0.005%), 0.33% acetic acid and 0.9% NaCl eardrops in clearing grommets blocked with harvested thick middle ear effusion fluid.. A blinded in-vitro study.. District general hospital.. A total of 473 grommets were blocked with freshly harvested unpooled thick middle ear effusion fluid obtained from 68 patients.. Patency of the grommets before and 7 days after intervention was ascertained by tympanometry and close visual inspection.. Instillation of eardrops leads to a statistically significant increase in the clearance of grommets as compared with not using any drops (chi2 = 14.3, d.f. = 5, P = 0.006). The numbers needed to treat were 2.8 for NaHCO3, 3.2 for 0.9% NaCl, 3.9 for 0.33% acetic Acid, 4.4 for Sofradex and 9.5 for H2O2 eardrops. Pair-wise comparison was only significant for comparison between 5% NaHCO3 and 3% H2O2 eardrops (Bonferroni corrected P = 0.01, odds ratio = 4.3, CI = 1.9-9.9).. Use of eardrops leads to a clinically and statistically significant increase in the clearance of blocked grommets. Of the five drops used, 5% NaHCO3 was the most efficacious and 3% H2O2 the least efficacious. Limitations of this in-vitro study are recognized and a prospective in-vivo double blind randomized controlled trial is planned.

Topics: Acetic Acid; Acoustic Impedance Tests; Administration, Topical; Adolescent; Adult; Anti-Inflammatory Agents; Child; Child, Preschool; Dexamethasone; Drug Combinations; Female; Framycetin; Gramicidin; Humans; In Vitro Techniques; Infant; Male; Middle Aged; Middle Ear Ventilation; Otitis Media with Effusion; Pharmaceutical Solutions; Sodium Bicarbonate; Sodium Chloride

Topics: Administration, Topical; Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Audiometry, Pure-Tone; Dexamethasone; Drug Therapy, Combination; Framycetin; Gentamicins; Gramicidin; Hearing Loss, Conductive; Humans; Male; Otitis Media with Effusion; Tympanic Membrane Perforation