Ramos A, Ayudarte F, de Miguel I, Cuyás J M, Cenjor C
Servicio de Otorrinolaringología, Hospital Universitario Insular de Gran Canaria.
Acta Otorrinolaringol Esp. 2003 Aug-Sep;54(7):485-90. doi: 10.1016/s0001-6519(03)78439-8.
A prospective study is presented. We carry out an analysis of the results obtained after treatment with different protocols of administration of ciprofloxacin, during the active phase in chronic otitis media and in chronic otorrhea.
A multicenter, prospective study is carried out, in 3 ENT departments, corresponding to 3 reference tertiary hospitals. 300 patients were included ranging from 5 to 73 years old, all were diagnosed of chronic disease of the middle ear: simple chronic otitis media (n = 128), chronic otitis with bone reabsorption (n = 57), cholesteatoma infection (n = 42) and postsurgery ear infection (n = 73). Patients were placed in 5 treatment groups: ciprofloxacin (oral administration) (only adults were included), topical ciprofloxacin (0.5%), topical ciprofloxacin (0.2%), topical ciprofloxacin (0.2%) plus oral ciprofloxacin and ciprofloxacin (0.3%) plus topical fluocinolone. There was a control group treated with polimixin plus neomicine and hidrocortison.
The most common isolated bacterias were: Pseudomonas aeruginosa and S. aureus. We found 19 resistant strains to ciprofloxacin. A better therapeutic response was observed in the topical administration groups. In topical administration, a difference was only observed in the cholesteatoma and chronic middle ear infection with bone reabsorption groups, in those patients that were administered the ciprofloxacin with fluocinolone.
Forms of topical treatment, with ciprofloxacin, in active infection of chronic disease of the middle ear, improve the results compared to oral administration. The association with of topical fluocinolone improves the results in the cases with cholesteatoma infection and chronic middle ear infection.
开展一项前瞻性研究。我们对慢性中耳炎和慢性耳漏活动期采用不同环丙沙星给药方案治疗后所获结果进行分析。
在3个耳鼻喉科科室（对应3家三级参考医院）开展一项多中心前瞻性研究。纳入300例年龄在5至73岁之间的患者，所有患者均被诊断为中耳慢性病：单纯性慢性中耳炎（n = 128）、伴有骨质吸收的慢性中耳炎（n = 57）、胆脂瘤感染（n = 42）及术后耳部感染（n = 73）。患者被分为5个治疗组：环丙沙星（口服）（仅纳入成人）、环丙沙星局部用药（0.5%）、环丙沙星局部用药（0.2%）、环丙沙星局部用药（0.2%）加口服环丙沙星以及环丙沙星（0.3%）加局部用氟轻松。有一个对照组采用多粘菌素加新霉素及氢化可的松进行治疗。
最常见的分离细菌为：铜绿假单胞菌和金黄色葡萄球菌。我们发现19株对环丙沙星耐药的菌株。在局部给药组观察到更好的治疗反应。在局部给药中，仅在胆脂瘤组以及伴有骨质吸收的慢性中耳感染组中，那些接受环丙沙星加氟轻松治疗的患者身上观察到差异。
在中耳慢性病的活动性感染中，与口服给药相比，环丙沙星局部治疗形式可改善治疗结果。在胆脂瘤感染和慢性中耳感染病例中，与局部用氟轻松联合使用可改善治疗结果。
