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局部应用环丙沙星、妥布霉素联合地塞米松治疗慢性化脓性中耳炎的疗效

[Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media].

作者信息

Kaygusuz Irfan, Karlidağ Turgut, Gök Uzeyir, Yalçin Sinasi, Keleş Erol, Demirbağ Erhan, Kaygusuz Türkkan Oztürk

机构信息

Firat Universitesi Firat Tip Merkezi KBB Kliniği, 23200 Elaziğ, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2002 Mar-Apr;9(2):106-11.

Abstract

OBJECTIVES

To evaluate the efficacy of topical ciprofloxacin and tobramycin with and without topical dexamethasone in the treatment of chronic suppurative otitis media without cholesteatoma.

PATIENTS AND METHODS

The study included 103 ears of 80 patients (49 males, 31 females; mean age 31 years; range 18 to 60 years) with chronic suppurative otitis media without cholesteatoma. The patients were randomly divided into four groups to receive topical applications of either ciprofloxacin and tobramycin alone, or in combination with dexamethasone. Cultures were obtained from the ears preoperatively and 24 hours after treatment.

RESULTS

Aerobic bacteria were isolated in 94.1% of patients before the treatment, the most common being Pseudomonas aeruginosa (38.9%). With dexamethasone, the clinical response for ciprofloxacin and tobramycin increased from 80% to 90% and from 70% to 75%, respectively, but this improvement was not significant (p > 0.03). Addition of dexamethasone to ciprofloxacin decreased the recovery period from 14 days to seven days, whereas no change (7 days) was observed with tobramycin.

CONCLUSION

The efficacy of ciprofloxacin and tobramycin were similar in the treatment of chronic suppurative otitis media. Addition of dexamethasone to ciprofloxacin decreased the treatment period.

摘要

目的

评估局部使用环丙沙星和妥布霉素以及联合或不联合局部使用地塞米松治疗非胆脂瘤型慢性化脓性中耳炎的疗效。

患者与方法

该研究纳入了80例(49例男性,31例女性;平均年龄31岁;范围18至60岁)非胆脂瘤型慢性化脓性中耳炎患者的103只耳。患者被随机分为四组,分别局部应用环丙沙星和妥布霉素单独治疗,或联合地塞米松治疗。术前及治疗后24小时从耳部获取培养物。

结果

治疗前94.1%的患者分离出需氧菌,最常见的是铜绿假单胞菌(38.9%)。联合地塞米松后,环丙沙星和妥布霉素的临床有效率分别从80%提高到90%以及从70%提高到75%,但这种改善不显著(p>0.03)。环丙沙星联合地塞米松可使恢复期从14天缩短至7天,而妥布霉素联合地塞米松则无变化(7天)。

结论

环丙沙星和妥布霉素在治疗非胆脂瘤型慢性化脓性中耳炎方面疗效相似。环丙沙星联合地塞米松可缩短治疗周期。

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