povidone-iodine and Otitis-Media-with-Effusion

The treatment of MRSA (methocillin resistant staphylococcus aureus) colonized middle ear is difficult. According to the guidelines, a MRSA colonized Patient is not to be treated with systemic antibiotics. The topical treatment shows the problem of the ototoxicity of most of the used antiseptic as well as antibiotic substances.. Selective literature review and consideration of the author's own clinical experience.. Antibiotic treatment options include aequeous Tetracyclin drops, aequeous chloramphenicol drops and quinolon ear drops (unfortunately the MRSA is resistent mostly). Antiseptics without ototoxic effects are the Burow's solution, Povidone-iode, acetic acid solutions and aequeous dequalinium solutions.

Topics: Acetates; Acetic Acid; Administration, Topical; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chloramphenicol; Dequalinium; Guideline Adherence; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Middle Ear Ventilation; Otitis Media with Effusion; Parotid Neoplasms; Pharmaceutical Solutions; Postoperative Complications; Povidone-Iodine; Quinolones; Staphylococcal Infections; Tetracycline

Otorrhea is the most common posttympanostomy complication. This study is designed to determine the efficacy of canal preparation prior to tympanostomy tube placement. One hundred thirty ears were prospectively randomized into prepared (Betadine and alcohol) and nonprepared (control) groups. Cultures obtained before, during, and after preparation were analyzed to determine the external canal flora and effectiveness of sterilization. Prepared ears and nonprepared control ears were examined for relation to otorrhea. Forty percent of the canals were sterile before preparation, and only 8% harbored suspected pathogenic organisms. Canal preparation successfully sterilized only 33% of the ears that contained bacteria. There was no difference in the otorrhea incidence among treatment groups (9.8%). Based on these bacteriologic and clinical findings, it is concluded that canal preparation with Betadine and alcohol does not reduce posttympanostomy otorrhea.

Topics: 1-Propanol; Child, Preschool; Ear Canal; Female; Humans; Incidence; Male; Middle Ear Ventilation; Otitis Media with Effusion; Povidone-Iodine; Prospective Studies; Surgical Wound Infection

Topics: Animals; Antibiotic Prophylaxis; Child; Chronic Disease; Diptera; Disease Susceptibility; Ear Canal; Humans; Larva; Male; Myiasis; Otitis Media with Effusion; Povidone-Iodine; Therapeutic Irrigation; Tympanic Membrane Perforation

Persistent otorrhea after tympanostomy tube placement in children is a common complication. Previous reports have suggested that bacteria present within the ear canal may be the cause of postoperative drainage. Preparation of the ear canal with povidone-iodine solutions has been recommended to decrease these infections. A prospective study evaluating the efficacy of povidone-iodine ear canal preparation before myringotomy and tube placement was performed in 111 children (220 ears) with documented chronic otitis media with effusion. One ear in each patient was prepared with povidone-iodine. The contralateral ear in each child was used as control. Postoperative otorrhea developed in seven (6.3%) of the treated ears within 14 days, compared to eleven (10%) of the ears in the control group. The difference was not statistically significant (p greater than 0.05). Purulent or mucoid middle ear effusions and edematous or granular middle ear mucosa were associated with a significantly higher incidence of postoperative otorrhea (p less than 0.05). This study suggests that postoperative otorrhea is generally a consequence of preoperative middle ear condition rather than contamination from the external canal. Antimicrobial therapy should be considered when purulent effusion or granulation tissue is seen.

Topics: Child; Child, Preschool; Female; Humans; Infant; Male; Middle Ear Ventilation; Otitis Media with Effusion; Postoperative Complications; Povidone; Povidone-Iodine; Premedication; Prospective Studies