Sindhuja M, Sheetal K, Mohana Karthikeyan S
Department of ENT, Karpaga Vinayaga Institute of Medical Sciences & Research Center, Madhuranthagam, India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3160-3164. doi: 10.1007/s12070-024-04634-7. Epub 2024 Mar 30.
Acute otitis externa also called as "Swimmers ear" is commonly seen in all age groups. It is a very common condition, severely painful, characterised by otalgia, otorrhoea, conductive hearing loss and an oedematous ear canal. There is dearth of evidence based treatment guidelines leading to difference of opinion in its treatment particularly in the usage of systemic antibiotics and local antibiotics. To evaluate the clinical efficacy of oral antibiotics in two different protocols in treatment of acute otitis externa. A total of 80 patients with clinically diagnosed otitis externa were included into the study. Group A treated with systemic antibiotics and Group B without antibiotics based on Senturia grading. Response to the treatment was assessed with otoscopic finding and visual analogue scale. Standard analysis was performed with the statistical p value of less than 0.05 which is considered as significant. Group A treated with oral antibiotics had better improvement of the VAS scores in S2b and S2c grades when compared with Group B. However, there was no significant difference in both groups with S1 and S2a grades with or without antibiotics. Oral antibiotics are effective only in cases with severe odema and higher grades of AOE. In cases with initial or milder to moderate AOE the role of antibiotics is still doubtful and hence use of antibiotics to be considered cautiously in this antibiotic resistance era. A combination of good local treatment and IG wicks can produce almost similar results without antibiotics except in severe odematous AOE cases.
The online version contains supplementary material available at 10.1007/s12070-024-04634-7.
急性外耳道炎也被称为“游泳者耳炎”，在所有年龄组中都很常见。它是一种非常常见的病症，疼痛剧烈，其特征为耳痛、耳漏、传导性听力损失和耳道水肿。缺乏基于证据的治疗指南导致在其治疗方面存在意见分歧，特别是在全身用抗生素和局部用抗生素的使用上。为评估口服抗生素在两种不同方案治疗急性外耳道炎中的临床疗效。共有80例临床诊断为外耳道炎的患者纳入研究。根据森图里亚分级，A组接受全身用抗生素治疗，B组不使用抗生素。通过耳镜检查结果和视觉模拟评分评估治疗反应。进行标准分析时统计学P值小于0.05被认为具有显著性。与B组相比，接受口服抗生素治疗的A组在S2b和S2c级时VAS评分改善更好。然而，在S1和S2a级时，无论有无抗生素，两组之间均无显著差异。口服抗生素仅在严重水肿和更高等级的急性外耳道炎病例中有效。在初始或轻度至中度急性外耳道炎病例中，抗生素的作用仍存疑问，因此在这个抗生素耐药时代，抗生素的使用应谨慎考虑。除严重水肿的急性外耳道炎病例外，良好的局部治疗和碘甘油纱条联合使用可在不使用抗生素的情况下产生几乎相似的结果。
在线版本包含可在10.1007/s12070-024-04634-7获取的补充材料。
