Goldenberg David, Golz Avishay, Netzer Aviram, Joachims Henry Zvi
Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center, and Technion Faculty of Medicine, Haifa, Israel.
Am J Otolaryngol. 2002 May-Jun;23(3):142-7. doi: 10.1053/ajot.2002.123461.
Acute external otitis (AEO) is a painful condition that results as a secondary infection of macerated skin and subcutaneous tissues of the external auditory canal. The most commonly causative microorganisms are Pseudomonas aeruginosa and Staphylococcus aureus. Classic management strategies include moisture prevention, cleansing of the canal and administration of topical antimicrobial agents in drop form, such as aminoglycosides and quinolones, at times in combination with steroid solutions. The objective of this study was to evaluate and compare the efficacy of topical otic powder, tobramycin drops and ciprofloxacin drops in patients suffering from AEO. MATERIALS AND MEASURES: A randomized prospective trial was performed to determine the efficacy of Auricularum powder (dexamethasone 10 mg, oxytetracycline HCl 90,000 U, polymyxin B Sulfate 100,000 U, nystatin 1,000,000 U; Trima, Serolam Laboratories, Germany) compared with ciprofloxacin (Ciloxan, Alcon Laboratories, Fort Worth, TX) and tobramycin (Tobrex, Alcon Laboratories) drops for the treatment of AEO. One hundred twenty patients who presented with signs and symptoms of AEO were enrolled. Inclusion criteria were: AEO diagnosed by an otolaryngologist, patient age 18 years, no prior treatment with other drops or systemic antibiotics, no sensitivity to any of the drugs used or their contents, and no perforation of the tympanic membrane. All patients were instructed to avoid moisture and wetness of the ear during the course of their treatment. After we received informed consent, a swab culture was taken, and the patient was randomly assigned topical treatment for 14 days.
Eighty-six percent of those treated with Auricularum powder were cured at day 3-4 after initial treatment. Seventy-seven percent of those treated with ciprofloxacin drops, and fifty-six percent of those treated with tobramycin were cured at that time. All 120 patients were cured by day 14.
The results show that topical treatment with Auricularum powder is an effective and rapid method for the treatment of AEO. Ciloxan also was effective in the treatment of AEO and relieved symptoms quickly and efficiently in a short period of time. Tobrex was effective in treating AEO, but our results show that relief of symptoms was slower than with the other drugs.
急性外耳道炎（AEO）是一种外耳道浸渍皮肤和皮下组织继发感染导致的疼痛性疾病。最常见的致病微生物是铜绿假单胞菌和金黄色葡萄球菌。经典的治疗策略包括预防潮湿、清洁耳道以及滴注局部抗菌药物，如氨基糖苷类和喹诺酮类，有时还会联合使用类固醇溶液。本研究的目的是评估和比较局部用耳粉、妥布霉素滴耳液和环丙沙星滴耳液对AEO患者的疗效。
进行了一项随机前瞻性试验，以确定耳粉（地塞米松10毫克、盐酸土霉素90,000单位、硫酸多粘菌素B 100,000单位、制霉菌素1,000,000单位；Trima，德国Serolam实验室）与环丙沙星（西洛欣，爱尔康实验室，得克萨斯州沃思堡）和妥布霉素（托百士，爱尔康实验室）滴耳液治疗AEO的疗效。招募了120例出现AEO症状和体征的患者。纳入标准为：由耳鼻喉科医生诊断为AEO，患者年龄≥18岁，此前未接受过其他滴耳液或全身用抗生素治疗，对所用任何药物或其成分无过敏反应，且鼓膜无穿孔。所有患者在治疗过程中均被要求避免耳部潮湿。在获得知情同意后，采集拭子进行培养，然后将患者随机分配接受局部治疗14天。
使用耳粉治疗的患者中有86%在初始治疗后第3 - 4天治愈。使用环丙沙星滴耳液治疗的患者中有77%，使用妥布霉素治疗的患者中有56%在此时治愈。所有120例患者在第14天均治愈。
结果表明，局部使用耳粉是治疗AEO的一种有效且快速的方法。西洛欣在治疗AEO方面也有效，能在短时间内迅速有效地缓解症状。托百士在治疗AEO方面有效，但我们的结果表明其症状缓解比其他药物慢。
