Arnes E, Dibb W L
Ostfold Central Hospital, Sarpsborg/Fredrikstad, Norway.
Curr Med Res Opin. 1993;13(3):182-6. doi: 10.1185/03007999309111548.
Thirty patients with otitis externa were included in a prospective, randomized, parallel group comparison study. Treatment regimens used were ciprofloxacin (2 mg/ml) as ear drops twice daily or drops containing oxytetracycline (5 mg/ml) polymyxin B (10,000 units/ml) and hydrocortisone (15 mg/ml) twice daily for 7 days. Evaluation was by clinical signs and symptoms and bacteriological findings from ear swabs prior to and 3 and 8 days after start of therapy, together with long-term follow-up if necessary. Sixteen patients were included in the ciprofloxacin and 14 in the combined antibiotic group. Six of 16 and 7 of 14 initial swabs, respectively, contained Pseudomonas aeruginosa. Mixed Gram-negative and Gram-positive pathogens were found in 3 patients in the ciprofloxacin group. All Gram-negative isolates were sensitive to ciprofloxacin. Microbiological evaluation showed rapid eradication of all bacterial pathogens in the ciprofloxacin group with 1 persistence of Candida albicans but eradication of Staphylococcus aureus in the same ear with marked clinical improvement. There was 1 case of supercolonization in the ciprofloxacin group with Candida parapsilosis. In the combined antibiotic group, there were 7 persistencies of which 5 were P. aeruginosa. No adverse effects were noted in either group. Treatment was assessed as a complete success in 14/16 and 5/14 cases, partial success in 2/16 and 4/14 cases and unsuccessful or indeterminate in 0/16 and 5/14 cases, respectively. Ciprofloxacin thus appears to be a useful and effective agent in the local therapy of otitis externa.
30例外耳道炎患者纳入一项前瞻性、随机、平行组对照研究。使用的治疗方案为环丙沙星（2mg/ml）耳滴剂，每日2次，或含土霉素（5mg/ml）、多粘菌素B（10000单位/ml）和氢化可的松（15mg/ml）的滴剂，每日2次，共7天。通过临床体征和症状、治疗开始前及开始后3天和8天耳拭子的细菌学检查结果进行评估，必要时进行长期随访。环丙沙星组纳入16例患者，联合抗生素组纳入14例患者。16例初始拭子中的6例和14例中的7例分别含有铜绿假单胞菌。环丙沙星组3例患者发现革兰氏阴性菌和革兰氏阳性菌混合病原体。所有革兰氏阴性菌分离株对环丙沙星敏感。微生物学评估显示，环丙沙星组所有细菌病原体均迅速根除，1例白色念珠菌持续存在，但同一耳中的金黄色葡萄球菌根除，临床有明显改善。环丙沙星组有1例近平滑念珠菌超定植。联合抗生素组有7例持续存在，其中5例为铜绿假单胞菌。两组均未观察到不良反应。治疗评估为完全成功的分别为14/16和5/14例，部分成功的分别为2/16和4/14例，不成功或不确定的分别为0/16和5/14例。因此，环丙沙星似乎是外耳道炎局部治疗中一种有用且有效的药物。
