Schmelzle Jason, Birtwhistle Richard V, Tan Andre K W
Department of Family Medicine, Queen's University, Kingston, ON, Canada.
Can Fam Physician. 2008 Aug;54(8):1123-7.
To review evidence regarding antibiotic treatment of acute otitis media in children with tympanostomy tubes and to discuss antibiotic resistance and ototoxicity.
MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched for relevant articles. Articles providing level I evidence(randomized controlled trials) for treatment were used. Key words used in the search included otitis media(MeSH), middle ear ventilation (MeSH), tympanostomy tubes, and otorrhea.
Tympanostomy tube insertion is a common procedure; acute otitis media is a frequent sequela. Treatment options include systemic or topical antibiotics with or without corticosteroids. The development of bacterial resistance to antibiotics and ototoxicity related to treatment are important considerations. There have been well-conducted randomized controlled trials of topical versus systemic antibiotic agents. Combined with proper ear cleaning and tragal pumping, topical fluoroquinolone agents offer the most effective treatment.
Current evidence suggests that a topical fluoroquinolone, with or without a corticosteroid, is the treatment of choice for acute otitis media with tympanostomy tubes.
回顾关于鼓膜置管儿童急性中耳炎抗生素治疗的证据，并讨论抗生素耐药性和耳毒性。
检索MEDLINE、EMBASE、Cochrane系统评价数据库和Cochrane对照试验中心注册库以查找相关文章。使用提供治疗一级证据（随机对照试验）的文章。检索中使用的关键词包括中耳炎（医学主题词）、中耳通气（医学主题词）、鼓膜置管和耳漏。
鼓膜置管是一种常见的手术；急性中耳炎是常见的后遗症。治疗选择包括使用或不使用皮质类固醇的全身或局部抗生素。细菌对抗生素的耐药性发展以及与治疗相关的耳毒性是重要的考虑因素。已经有关于局部与全身抗生素制剂的良好随机对照试验。结合适当的耳部清洁和耳屏按压，局部氟喹诺酮类药物提供最有效的治疗。
目前的证据表明，使用或不使用皮质类固醇的局部氟喹诺酮类药物是鼓膜置管急性中耳炎的治疗选择。
