oxytetracycline--anhydrous and Otitis-Externa

The present study was undertaken to compare the clinical benefits of prescribing ear drops containing 0.05% solution of betamethasone dipropionate (BD), and ear drops containing hydrocortisone with oxytetracycline hydrochloride and polymyxin B (HCPB), for topical treatment of external otitis. Fifty-one patients were enrolled in this open randomized, parallel-group, multicentre study, performed in eight different ENT departments. The patients were randomly assigned to one of the two treatment groups: BD (n = 26) and HCPB (n = 25). Only ENT specialists investigated the patients. Bacterial and fungal cultures were raised on days 1 and 11, using swabbed material from ear canals. Twice daily the patients recorded their symptoms during the acute phase, using special diary cards.BD proved a significantly more effective cure than HCPB during the acute phase of external otitis and afforded a lower relapse frequency during a six-month follow-up period. The patients of the BD group were significantly less troubled by itching (p < 0.01) than those in the HCPB group. On day 11, at the end of the acute phase, growth of bacteria (p = 0.03) and fungi (p < 0.01) was less frequent in the BD group than in the HCPB group. No serious adverse events occurred, and those minor events observed were comparable between the two groups.Our conclusion is that the group III steroid solution, BD, cured the external otitis more effectively than did the HCPB solution, whether infected by bacteria or by fungi. No difference was evident regarding adverse effects. Furthermore, price favours a solution without any antibiotic component. In view of these observations, a group III steroid solution ought to be the preferred remedy for external otitis, whether infected or not.

Topics: Administration, Topical; Adult; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Betamethasone; Drug Combinations; Ear Canal; Female; Humans; Hydrocortisone; Male; Middle Aged; Otitis Externa; Oxytetracycline; Polymyxin B; Treatment Outcome

Otitis externa (OE) is a common disorder which can cause severe pain and discomfort with discharge and hearing loss. The majority of topical preparations for OE treatment contain a combination of steroids and antibiotics and are administered as ear drops. Otic powder preparations are less common. We found no studies which compared the efficacy of the two dosage forms.. The purpose of the study was to compare the healing process of the external ear canal when treated locally either with otic powder (Auricularum), a preparation containing antibiotic, steroidal and antimycotic components, or with otic drops (Dex-Otic), a commercial ear drop preparation containing antibiotic and steroidal components.. The study was designed as an open, randomised, comparative clinical trial. Ambulatory patients suffering from OE were examined by an ear specialist and randomly divided into an otic powder (Auricularum) treatment group and an ear drop (Dex-Otic) treatment group. Each treatment group was treated in accordance with the daily doses recommended by the manufacturers. Patients were treated for a period of 14 days and examined on days 0, 3, 7, 10 and 14. Clinical signs and symptoms recorded were pain, erythema, swelling and discharge.. A total of 67 patients entered the study. The probability of healing within 7 days was 74% in the otic powder group as opposed to 40% in the ear drops group (log rank test, p = 0.0013). The probability of total pain relief after 3 days of treatment was 60% in the otic powder group compared to 53% in the ear drops group (log rank test, p = 0.0001).. We conclude that treatment with an otic powder (Auricularum) may promote earlier healing and pain relief than does treatment with otic drops (Dex-Otic).

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Anti-Inflammatory Agents; Chemistry, Pharmaceutical; Dexamethasone; Drug Combinations; Female; Humans; Israel; Male; Middle Aged; Nystatin; Otitis Externa; Oxytetracycline; Polymyxin B; Treatment Outcome

Thirty patients with otitis externa were included in a prospective, randomized, parallel group comparison study. Treatment regimens used were ciprofloxacin (2 mg/ml) as ear drops twice daily or drops containing oxytetracycline (5 mg/ml) polymyxin B (10,000 units/ml) and hydrocortisone (15 mg/ml) twice daily for 7 days. Evaluation was by clinical signs and symptoms and bacteriological findings from ear swabs prior to and 3 and 8 days after start of therapy, together with long-term follow-up if necessary. Sixteen patients were included in the ciprofloxacin and 14 in the combined antibiotic group. Six of 16 and 7 of 14 initial swabs, respectively, contained Pseudomonas aeruginosa. Mixed Gram-negative and Gram-positive pathogens were found in 3 patients in the ciprofloxacin group. All Gram-negative isolates were sensitive to ciprofloxacin. Microbiological evaluation showed rapid eradication of all bacterial pathogens in the ciprofloxacin group with 1 persistence of Candida albicans but eradication of Staphylococcus aureus in the same ear with marked clinical improvement. There was 1 case of supercolonization in the ciprofloxacin group with Candida parapsilosis. In the combined antibiotic group, there were 7 persistencies of which 5 were P. aeruginosa. No adverse effects were noted in either group. Treatment was assessed as a complete success in 14/16 and 5/14 cases, partial success in 2/16 and 4/14 cases and unsuccessful or indeterminate in 0/16 and 5/14 cases, respectively. Ciprofloxacin thus appears to be a useful and effective agent in the local therapy of otitis externa.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Ciprofloxacin; Drug Combinations; Drug Therapy, Combination; Female; Humans; Hydrocortisone; Instillation, Drug; Male; Microbial Sensitivity Tests; Middle Aged; Otitis Externa; Oxytetracycline; Polymyxin B; Prospective Studies; Treatment Failure

Ten patients with bilateral moderate or severe otitis externa were studied. Following aural toilet each patient was subjected to two different treatments: one ear had alternate day dressings containing a topical antibiotic/steroid mixture, while the external canal of the other was filled with the same topical preparation (sump filling). Improvement in the severity of the otitis externa was assessed after 1 week. 9 out of 10 ear canals improved in each group. An estimate of the relative cost of each treatment was made and sump filling was found to be less expensive. The results suggest that sump filling is a low cost alternative to standard treatment in moderate and severe otitis externa.

Topics: Administration, Topical; Bandages; Fluocinolone Acetonide; Gentamicins; Humans; Injections; Nystatin; Otitis Externa; Oxytetracycline; Prospective Studies; Syringes

In a single blind, randomized study, 46 patients with acute external otitis were treated with either oxytetracycline/hydrocortisone with polymyxin B (TPB) or hydrocortisone-17-alpha-butyrate eardrops for 7 days. Pseudomonas pyocyanea, Staphylococcus epidermidis and Staph. aureus were the microorganisms most frequently found in the ear canal. Fungi were not found in any culture. The overall cure rate was 80%. No significant difference in therapeutic efficacy was noted between the preparations except regarding Staph. aureus, which was cultured from 17% of the patients. Although the butyrate solution did not contain any antibiotic supplement, it seemed to be more effective than TPB in treating the staphylococcal infections. These findings suggest that such other factors as the hydrogen ion concentration, the steroid potency or the vehicle per se are of importance for the successful treatment of acute external otitis.

Topics: Acute Disease; Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Bacterial Infections; Child; Drug Combinations; Female; Humans; Hydrocortisone; Male; Middle Aged; Otitis Externa; Oxytetracycline; Polymyxin B; Polymyxins; Randomized Controlled Trials as Topic; Single-Blind Method

In a randomized trial, 55 patients with acute external otitis were treated with either topical framycitin/gramicidin (Sofradex) or oxytetracycline/hydrocortisone (Terracortril) with polymyxin B (TPB) ear-drops for 1 week. Staphylococcus aureus and Pseudomonas pyocyanea were the bacteria most frequently found in the ear canal; 78% of the patients were cured. However, no significant differences in therapy were found when either of the preparations was used. S. aureus seemed to be most resistant to treatment, while P. pyocyanea was less of a therapeutic problem. Additionally, previous episodes of external otitis or other skin diseases did not seem to influence any treatment given.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Bacterial Infections; Child; Clinical Trials as Topic; Dexamethasone; Drug Combinations; Ear Canal; Female; Framycetin; Gramicidin; Humans; Hydrocortisone; Male; Middle Aged; Otitis Externa; Oxytetracycline; Polymyxin B; Polymyxins; Pseudomonas; Random Allocation; Staphylococcus aureus

Irrespective of the microbial agent, group III steroid solution cured external otitis efficiently in a rat model. The addition of antibiotic components to steroid solutions for the treatment of external otitis is of questionable validity.. External otitis, caused by infection with either Pseudomonas aeruginosa or Candida albicans, was established in a rat model and the treatment efficacy of a group III steroid solution was studied.. Three treatments were studied: (i) a group III steroid solution; (ii) a group I steroid combined with two antibiotic components; and (iii) a saline solution. A scoring scale was used to evaluate the characteristics of the ear canal skin. Bacteriological and fungal samples were collected for culturing and ear canal skin biopsies were taken for structural analyses.. It was possible to cause P. aeruginosa and C. albicans infections in an animal model. In the P. aeruginosa-infected animals, only the group III steroid treatment cured all the animals. In the C. albicans-infected animals, group III steroid treatment resolved external otitis faster than the other treatment modalities.

Topics: Administration, Topical; Animals; Anti-Bacterial Agents; Betamethasone; Candidiasis; Colony-Forming Units Assay; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Therapy, Combination; Ear Canal; Hydrocortisone; Male; Otitis Externa; Oxytetracycline; Polymyxin B; Pseudomonas Infections; Rats; Treatment Outcome

Combinations of EDTA-tromethamine and 7 antimicrobial agents (chloramphenicol, nalidixic acid, oxytetracycline, penicillin, polymyxin-B, streptomycin, and triple sulfa) were tested for synergistic activities against Pseudomonas aeruginosa. Three in vitro tests were used, including minimal inhibitory concentrations of the drugs, a 2-dimensional Microtiter checkerboard technique, and bacterial inhibition studies. A synergistic inhibitory action was observed with combinations of EDTA-tromethamine plus penicillin and EDTA-tromethamine plus oxytetracycline. When chloramphenicol, streptomycin, nalidixic acid, polymyxin-B, or triple sulfa was mixed with EDTA-tromethamine, synergistic action did not occur.

Topics: Animals; Anti-Bacterial Agents; Dog Diseases; Dogs; Drug Combinations; Drug Synergism; Drug Therapy, Combination; Edetic Acid; Otitis Externa; Oxytetracycline; Penicillin Resistance; Penicillins; Pseudomonas aeruginosa; Pseudomonas Infections; Tromethamine

Topics: Animals; Dog Diseases; Dogs; Nitrofurazone; Ointments; Otitis Externa; Oxytetracycline

Topics: Adult; Antifungal Agents; Dexamethasone; Female; Humans; Middle Aged; Natamycin; Ophthalmic Solutions; Otitis; Otitis Externa; Otitis Media; Oxytetracycline; Tetracaine

Topics: Chronic Disease; Dexamethasone; Humans; Natamycin; Otitis Externa; Oxytetracycline; Tetracaine

Topics: Antifungal Agents; Dexamethasone; Humans; Mycoses; Natamycin; Otitis Externa; Oxytetracycline; Tetracaine

Topics: Adolescent; Adult; Aged; Anesthetics, Local; Antifungal Agents; Child; Dexamethasone; Ear Diseases; Female; Humans; Male; Middle Aged; Otitis; Otitis Externa; Otitis Media; Oxytetracycline

Topics: Administration, Topical; Anti-Inflammatory Agents; Humans; Hydrocortisone; Otitis Externa; Otitis Media; Oxytetracycline

Topics: Communicable Diseases; Humans; Maxillary Sinus; Otitis Externa; Otitis Media; Oxytetracycline; Rhinitis; Rhinitis, Atrophic; Sinusitis; Sulfathiazoles; Suppuration; Trypsin

Topics: Acridines; Anti-Bacterial Agents; Anti-Infective Agents, Local; Antifungal Agents; Aspergillosis; Bromides; Ear, External; Ear, Middle; Fungi; Gentian Violet; Humans; Mercury Compounds; Methylene Blue; Mycoses; Otitis Externa; Otitis Media; Oxytetracycline; Salicylic Acid

Topics: Humans; Hydrocortisone; Otitis Externa; Oxytetracycline

Topics: Drug Combinations; Humans; Hydrocortisone; Otitis Externa; Oxytetracycline; Suspensions

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Humans; Otitis Externa; Otitis Media; Oxytetracycline; Polymyxins

Topics: Anti-Bacterial Agents; Furans; Humans; Otitis Externa; Oxytetracycline; Sulfanilamide; Sulfanilamides; Sulfonamides