Antibiotics versus topical antiseptics for chronic suppurative otitis media
Información
- DOI:
- https://doi.org/10.1002/14651858.CD013056Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 22 junio 2018see what's new
- Tipo:
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- Intervention
- Etapa:
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- Protocol
- Grupo Editorial Cochrane:
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Grupo Cochrane de Enfermedades de oído, nariz y garganta
- Copyright:
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- Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Karen Head: helped to scope, design and write the protocol.
Lee Yee Chong: scoped, designed and wrote the protocol.
Mahmood F Bhutta: helped to scope, design and write the protocol; clinical guidance at all stages of project scoping and protocol development.
Peter S Morris: clinical guidance at all stages of protocol development.
Shyan Vijayasekaran: clinical guidance at all stages of project scoping and protocol development.
Martin J Burton: clinical guidance at all stages of project scoping and protocol development.
Anne GM Schilder: clinical guidance at all stages of project scoping and protocol development.
Christopher G Brennan‐Jones: helped to scope, design and write the protocol; clinical guidance at all stages of project scoping and protocol development.
Sources of support
Internal sources
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No sources of support supplied
External sources
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National Institute for Health Research, UK.
Infrastructure funding for Cochrane ENT
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NHMRC Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children, Australia.
Declarations of interest
Karen Head: none known.
Lee Yee Chong: none known.
Mahmood F Bhutta: Mahmood Bhutta has received an honorarium from Novus Therapeutics for advice on an experimental treatment for otitis media (not related to any treatment in this review).
Peter S Morris:
Shyan Vijayasekaran:
Martin J Burton: Professor Martin Burton is joint Co‐ordinating Editor of Cochrane ENT, but had no role in the editorial process for this review.
Anne GM Schilder: Professor Anne Schilder is joint Co‐ordinating Editor of Cochrane ENT, but had no role in the editorial process for this review. Her evidENT team at UCL is supported in part by the National Institute of Health Research (NIHR) University College London Hospitals Biomedical Research Centre. The research is funded by the NIHR and EU Horizon2020. She is the national chair of the NIHR Clinical Research Network ENT Specialty. She is the Surgical Specialty Lead for ENT for the Royal College of Surgeons of England's Clinical Trials Initiative. In her role as director of the NIHR UCLH BRC Deafness and Hearing Problems Theme, she acts as an advisor on clinical trial design and delivery to a range of biotech companies, most currently Novus Therapeutics.
Christopher G Brennan‐Jones: none known.
Acknowledgements
This project was funded by the NHMRC Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children (NHMRC CRE_ICHEAR). The contents of the publications arising from this work are solely the responsibility of the authors and do not reflect the views of NHMRC.
We are grateful to Mr Iain Swan for peer reviewing this protocol, and to consumer referee Joan Blakely for her helpful comments. We would also like to thank Dr. Adrian James, as Acting Co‐ordinating Editor for Cochrane ENT, for his insightful comments and advice.
We would like to sincerely thank Jenny Bellorini and Samantha Cox from the Cochrane ENT team for their invaluable help, which has enabled the completion of this suite of protocols. We would also like to acknowledge the clinicians, researchers and consumers who contributed to a scoping consultation on this topic.
This project was supported by the National Institute for Health Research, via Cochrane Infrastructure, Cochrane Programme Grant or Cochrane Incentive funding to Cochrane ENT. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.
Version history
| Published | Title | Stage | Authors | Version |
| 2020 Jan 05 | Antibiotics versus topical antiseptics for chronic suppurative otitis media | Review | Karen Head, Lee-Yee Chong, Mahmood F Bhutta, Peter S Morris, Shyan Vijayasekaran, Martin J Burton, Anne GM Schilder, Christopher G Brennan-Jones | |
| 2018 Jun 22 | Antibiotics versus topical antiseptics for chronic suppurative otitis media | Protocol | Karen Head, Lee‐Yee Chong, Mahmood F Bhutta, Peter S Morris, Shyan Vijayasekaran, Martin J Burton, Anne GM Schilder, Christopher G Brennan‐Jones | |
PICO
| Topical antibiotics with steroids | Topical antibiotics | Systemic antibiotics | Topical antiseptics | Aural toileting (ear cleaning) | |
| Topical antibiotics with steroids | Review CSOM‐4 | ||||
| Topical antibiotics | Review CSOM‐4 | Review CSOM‐1 | |||
| Systemic antibiotics | Review CSOM‐4 | Review CSOM‐3 | Review CSOM‐2 | ||
| Topical antiseptics | Review CSOM‐4 | Review CSOM‐6 | Review CSOM‐6 | Review CSOM‐5 | |
| Aural toileting | Review CSOM‐4 | Not reviewed | Not reviewed | Not reviewed | Review CSOM‐7 |
| Placebo (or no intervention) | Review CSOM‐4 | Review CSOM‐1 | Review CSOM‐2 | Review CSOM‐5 | Review CSOM‐7 |
| CSOM‐1: Topical antibiotics for chronic suppurative otitis media (Brennan‐Jones 2018a). CSOM‐2: Systemic antibiotics for chronic suppurative otitis media (Chong 2018a). CSOM‐3: Topical versus systemic antibiotics for chronic suppurative otitis media (Chong 2018b). CSOM‐4: Topical antibiotics with steroids for chronic suppurative otitis media (Brennan‐Jones 2018b). CSOM‐5: Topical antiseptics for chronic suppurative otitis media (Head 2018a). CSOM‐6: Antibiotics versus topical antiseptics for chronic suppurative otitis media (Head 2018b). CSOM‐7: Aural toilet (ear cleaning) for chronic suppurative otitis media (Bhutta 2018). | |||||
| Class of antibiotics | Examples | Route of administration |
| Quinolones | Ciprofloxacin, ofloxacin, levofloxacin | Oral, intravenous, topical |
| Aminoglycosides | Gentamicin, tobramycin | Topical or parenteral |
| Neomycin/framycetin | Only topical | |
| Cephalosporins | Ceftazidime | Parenteral |
| Penicillins | Ticarcillin plus clavulanic acid | Parenteral |
| Monobactams | Aztreonam | Parenteral |
| Antiseptic agent used aurally | Target and mechanism of action |
| Rubbing alcohol (ethanol, isopropanol) | Penetrating agents that cause loss of cellular membrane function, leading to release of intracellular components, denaturing of proteins, and inhibition of DNA, RNA, protein and peptidoglycan synthesis. |
| Povidone iodine | Highly active oxidising agents that destroy cellular activity of proteins. Disrupts oxidative phosphorylation and membrane‐associated activities. Iodine reacts with cysteine and methionine thiol groups, nucleotides and fatty acids, resulting in cell death. |
| Chlorhexidine | Membrane‐active agents that damage cell wall and outer membrane, resulting in collapse of membrane potential and intracellular leakage. Enhanced passive diffusion mediates further uptake, causing coagulation of cytosol. |
| Hydrogen peroxide | Produces hydroxyl free radicals that function as oxidants, which react with lipids, proteins and DNA. Sulfhydryl groups and double bonds are targeted in particular, thus increasing cell permeability. |
| Boric acid | It is likely that the change in the pH media of the ear canal interrupts the growth of bacteria by affecting the amino acid, which causes alteration in the three‐dimensional structure of bacterial enzymes. Extreme changes in pH cause protein denaturation. |
| Aluminium acetate/acetic acid | Acetic acid changes the pH media of the ear canal and interrupts the growth of bacteria by affecting the amino acid, which causes alteration in the three‐dimensional structure of bacterial enzymes. Extreme changes in pH cause protein denaturation. Aluminium acetate is an astringent that helps reduce itching, stinging and inflammation. |
| Sources: Gupta 2015; McDonnell 1999; Sheldon 2005. | |
