Clayton M I, Osborne J E, Rutherford D, Rivron R P
ENT Department, Bradford Royal Infirmary, West Yorkshire.
Clin Otolaryngol Allied Sci. 1990 Feb;15(1):7-10. doi: 10.1111/j.1365-2273.1990.tb00425.x.
The clinical efficacy was assessed of a topical antiseptic (aluminium acetate) and a topical antibiotic (gentamicin sulphate) for the initial treatment of otorrhoea. Evidence of resistant organisms developing to either treatments after 9 and 21 days was also examined. 139 affected ears were entered into the trial and of these, 102 (74%) completed the study. Improvement in the otorrhoea occurred in 68% of ears treated with gentamicin and 67% of ears treated with aluminium acetate, with no significant difference between the two treatments. No resistant organisms to aluminium acetate were encountered. Twelve gentamicin-treated ears had gentamicin-resistant organisms at presentation and one patient developed a gentamicin-resistant Pseudomonas during treatment. We therefore recommend a topical antiseptic such as aluminium acetate rather than a topical antibiotic in the initial treatment of otorrhoea on the grounds of cost, avoidance of resistance and toxicity.
评估了一种外用防腐剂（醋酸铝）和一种外用抗生素（硫酸庆大霉素）对耳漏初始治疗的临床疗效。还检查了9天和21天后两种治疗中出现耐药菌的证据。139只患耳进入试验，其中102只（74%）完成了研究。庆大霉素治疗的耳中68%耳漏有所改善，醋酸铝治疗的耳中67%耳漏有所改善，两种治疗之间无显著差异。未发现对醋酸铝耐药的细菌。12只接受庆大霉素治疗的耳在就诊时就有庆大霉素耐药菌，1例患者在治疗期间出现了对庆大霉素耐药的铜绿假单胞菌。因此，基于成本、避免耐药性和毒性等因素，我们建议在耳漏的初始治疗中使用外用防腐剂如醋酸铝而非外用抗生素。
