Rotimi V O, Olabiyi D A, Banjo T O, Okeowo P A
Department of Medical Microbiology & Parasitology, College of Medicine, Lagos University Teaching Hospital, Nigeria.
West Afr J Med. 1990 Apr-Jun;9(2):89-97.
Chronic suppurative otitis media is major health problem seen frequently in the ENT clinics in Nigeria and the outcome of most medical management in the past have been disappointing. A comparative randomised clinical trial involving combination therapies with systemic clindamycin, metronidazole, lincomycin, each with gentamicin, was conducted on a total of 14 patients. At the end of one week, and three-week, follow-up end points the clinical response with bacteriological cure were, for clindamycin and gentamicin 21%, metronidazole and gentamicin 33%, lincomycin and gentamicin 22%, and the control (aural toilet alone) 14%. However, when the clinical response was measured only by the ceasation of discharge, the outcome was more impressive. By this assessment the clinical response with clindamycin and gentamicin was 52% of the 140 patients, metronidazole and gentamicin 69%, lincomycin and gentamicin 47%, and the control 24%. The metronidazole and gentamicin regime was significantly more effective than the other regimes and it is suggested for use in prophylactic treatment of CSOM patients undergoing surgical procedures.
慢性化脓性中耳炎是尼日利亚耳鼻喉科诊所中常见的主要健康问题，过去大多数药物治疗的效果都不尽人意。一项针对14名患者的比较随机临床试验，采用了克林霉素、甲硝唑、林可霉素分别与庆大霉素联合治疗的方法。在一周和三周的随访终点时，克林霉素与庆大霉素联合治疗的细菌学治愈率为21%，甲硝唑与庆大霉素联合治疗为33%，林可霉素与庆大霉素联合治疗为22%，而对照组（仅进行耳部冲洗）为14%。然而，当仅通过停止流脓来衡量临床反应时，结果更令人印象深刻。通过这种评估，在140名患者中，克林霉素与庆大霉素联合治疗的临床反应率为52%，甲硝唑与庆大霉素联合治疗为69%，林可霉素与庆大霉素联合治疗为47%，对照组为24%。甲硝唑与庆大霉素联合治疗方案明显比其他方案更有效，建议用于接受外科手术的慢性化脓性中耳炎患者的预防性治疗。
