Topical antibiotics with steroids for chronic suppurative otitis media
Abstract
Background: Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity that is characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Topical antibiotics aim to kill or inhibit the growth of micro-organisms that may be responsible for the infection. Antibiotics can be used alone or in addition to other CSOM treatments, such as steroids, antiseptics or ear cleaning ('aural toileting'). Antibiotics are commonly prescribed in combined preparations with steroids. This is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM. It is the first update of the original review published in 2020.
Objectives: This review aims to assess the effects of adding a topical steroid to topical antibiotics in the treatment of people with chronic suppurative otitis media.
Search methods: We searched the Cochrane ENT Specialised Register, CENTRAL, Ovid MEDLINE, Ovid EMBASE and five other databases on 15 June 2022. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP).
Selection criteria: We included randomised controlled trials (RCTs) that involved participants (adults and children) with chronic ear discharge of unknown cause or CSOM, where the ear discharge had continued for…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,044 participants or records.
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