Department of Otolaryngology, University of Florida College of Medicine, Gainesville, Florida.
Otol Neurotol. 2019 Dec;40(10):1386-1391. doi: 10.1097/MAO.0000000000002371.
Commercial quinolone ear drops may promote the development of perforations (TMPs) in intact tympanic membrane (TMs).
Quinolone ear drops have been associated with TMPs after myringotomy +/- tube placement in a drug-specific manner and potentiation by steroids.
Rats were randomized to six groups (10/group), with one ear receiving otic instillation of dexamethasone, ofloxacin, ciprofloxacin, ofloxacin + dexamethasone, ciprofloxacin + dexamethasone, or neomycin + polymyxin + hydrocortisone-all commercial formulations and at standard clinical concentrations-and the contralateral ear receiving saline, twice daily for 10 days. TMs were assessed over 42 days.
No TMPs were seen in ears treated with saline, dexamethasone, or neomycin. At day 10, TMPs were seen in one of 10 ofloxacin- and three of 10 ciprofloxacin + dexamethasone-treated ears (p = 0.038). At day 14, the ofloxacin TMP healed. In contrast, the three ciprofloxacin + dexamethasone TMPs remained and one new TMP developed in this group. A ciprofloxacin and an ofloxacin + dexamethasone-treated ears also had TMPs (p = 0.023). By day 21, the ofloxacin + dexamethasone TMP and two of four of the ciprofloxacin + dexamethasone TMPs healed but two new TMPs were seen in ciprofloxacin + dexamethasone ears (p = 0.0006). At day 28, 1 of 10 ciprofloxacin and 4 of 10 ciprofloxacin + dexamethasone-treated ears had TMPs (p = 0.0006). By day 35, only one ciprofloxacin + dexamethasone had TMP (p = 0.42). All TMPS were healed at day 42.
Application of commercial quinolone ear drops can cause TMPs in intact TMs. This effect appears to be drug-specific and potentiated by steroids.
商业喹诺酮滴耳液可能会促进完整鼓膜穿孔（TMPs）的发展。
在鼓膜切开术 +/- 管放置后，喹诺酮滴耳液与 TMPs 有关，且与类固醇有协同作用。
大鼠随机分为六组（每组 10 只），一侧耳朵接受地塞米松、氧氟沙星、环丙沙星、氧氟沙星+地塞米松、环丙沙星+地塞米松或新霉素+多粘菌素+氢化可的松滴耳——均为商业制剂且浓度符合临床标准——对侧耳朵接受生理盐水，每日两次，共 10 天。在 42 天内评估鼓膜。
用生理盐水、地塞米松或新霉素治疗的耳朵未见 TMP。在第 10 天，10 只氧氟沙星组中有 1 只和 10 只环丙沙星+地塞米松组中有 3 只耳朵出现 TMP（p=0.038）。在第 14 天，氧氟沙星 TMP 愈合。相比之下，在该组中，3 只环丙沙星+地塞米松 TMP 仍然存在，又出现了 1 个新的 TMP。1 只氧氟沙星和 1 只环丙沙星+地塞米松组的耳朵也有 TMP（p=0.023）。第 21 天，氧氟沙星+地塞米松 TMP 和 4 只环丙沙星+地塞米松 TMP 中有 2 只愈合，但在环丙沙星+地塞米松组中又出现了 2 个新的 TMP（p=0.0006）。第 28 天，10 只氧氟沙星中有 1 只和 10 只环丙沙星+地塞米松组中有 4 只耳朵出现 TMP（p=0.0006）。第 35 天，只有 1 只环丙沙星+地塞米松出现 TMP（p=0.42）。所有 TMP 都在第 42 天愈合。
商业喹诺酮滴耳液的应用可能会导致完整鼓膜穿孔。这种作用似乎是药物特异性的，并且与类固醇有协同作用。
