Department of Otolaryngology-Head & Neck Surgery, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
Department of Pediatrics, 12314Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
Ear Nose Throat J. 2020 Nov;99(1_suppl):30S-34S. doi: 10.1177/0145561320912885. Epub 2020 Mar 17.
Only a few medications have a United States Food and Drug Administration indications for prevention and/or treatment of infections in patients with tympanic perforations or tympanostomy tubes. We examined 3 off-label agents that have become important in tympanostomy tube care hoping to demonstrate the effectiveness and safety of each in experimental assays and human application.
Computerized literature review.
(1) Oxymetazoline nasal spray applied at the time of surgery is equivalent to fluoroquinolone ear drops in the prevention of early postsurgical otorrhea and tympanostomy tube occlusion at the first postoperative visit. (2) Topical mupirocin 2% ointment is effective alone or in combination with culture-directed systemic therapy for the treatment of tympanostomy tube otorrhea caused by community-acquired, methicillin-resistant . (3) Topical clotrimazole 1% cream is highly active against the common yeast and fungi that cause otomycosis. A single application after microscopic debridement will cure fungal tympanostomy tube otorrhea in most cases. None of these 3 agents is ototoxic in animal histological or physiological studies, and each has proved safe in long-term clinical use.
Oxymetazoline nasal spray, mupirocin ointment, and clotrimazole cream are safe and effective as off-label medications for tympanostomy tube care in children.
仅有少数几种药物被美国食品和药物管理局批准用于预防和/或治疗鼓膜穿孔或鼓室置管患者的感染。我们研究了 3 种非适应证药物，它们在鼓室置管护理中变得非常重要，希望在实验和人体应用中证明每种药物的有效性和安全性。
计算机文献检索。
（1）手术时使用羟甲唑啉鼻喷雾剂与氟喹诺酮滴耳液等效，可预防早期术后耳漏和首次术后就诊时鼓室置管堵塞。（2）局部莫匹罗星 2%软膏单独使用或联合培养指导下的全身治疗对社区获得性耐甲氧西林金黄色葡萄球菌引起的鼓室置管耳漏有效。（3）局部克霉唑 1%乳膏对引起耳真菌病的常见酵母和真菌具有高度活性。在显微镜清创后单次应用可治愈大多数情况下的真菌性鼓室置管耳漏。在动物组织学或生理学研究中，这 3 种药物均无耳毒性，并且每种药物在长期临床应用中均已被证明是安全的。
羟甲唑啉鼻喷雾剂、莫匹罗星软膏和克霉唑乳膏作为非适应证药物，可安全有效地用于儿童鼓室置管护理。
