Is adding an Oral Antibiotic with the Topical Antibiotic-Steroid Useful in Treatment of Uncomplicated Acute Otitis Externa in Immunocompetent Patients?

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Ahmed Muhei Rasheed
Shamil Abbood Hilal
Azzam Muhsin Abbas


Acute otitis externa, Visual analogue scale, Topical tubramycin-hydrocortisone drops, Ciprofloxacin tablets.


Background: Acute otitis externa (AOE) is a common disease encountered in otolaryngological practice, it is mainly bacterial in origin.AOE can cause severe otalgia and can interrupt the daily activeties, however, bed rest is required in about 20% of the patients.

Aim: To evaluate the usefulness of adding an oral antibiotic with the topical antibiotic-steroid in the treatment of uncomplicated AOE which is limited to the ear canal in immunocompetent patients.

Patients and methods: Aprospective comparative clinical study was conducted in the department of otolaryngology at Al-Jerrahat Teaching Hospital and Private Clinic, Baghdad, Iraq, during the period from April 2020 through October 2021. A sixty eight immunocompetent patients (39 females & 29 males), diagnosed as cases of uncomplicated AOE which is limited to the ear canal, were included in this study. The patients were allocated in two groups. Patients in group A were treated with topical tobramycin 0.3% -dexamethasone 0.1%  drops, while patients in group B were recieved the same treatment as group A patients plus oral ciprofloxacin tabletes 500 mg twice daily . The patients were followed upfrom day to day until complete resolution of pain and odema. Pain was assessed by visual analogue scali (VAS) scores, while odema was graded by dividing the ear canal by imaginary horizontal and vertical lines into 4 quarters. The post-treatment pain VAS scores and odema grades of both groups were compared. Statistical analysis using T-test was done to calculate P value in orded to find if there is significant difference regarding the resolution of pain and odema between group A and group B.

Results: During the whole follow up period there was no significant difference between group A and group B patients regarding the resolution of pain and odema (P value more than 0.05).

Conclusion: There is no significant benefit of adding an oral antibiotic with the topical antibiotic-steroid in the treatment of uncomplicated AOE limited to the ear canal in immunocompetent patients.

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