Prospective randomised single-blind controlled trial of glacial acetic acid versus glacial acetic acid, neomycin sulphate and dexamethasone spray in otitis externa and infected mastoid cavities
Objectives: The literature reports the merits of antibacterial, antibiotic and steroid agents in treating otological infections but no controlled clinical trial has directly compared 2% glacial acetic acid (EarCalm; Stafford‐Miller Ltd, Brentford, UK) against 2% glacial acetic acid, 0.1% dexamethas...
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| Veröffentlicht in: | Clinical otolaryngology 2006-12, Vol.31 (6), p.504-507 |
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| creator | Johnston, M.N. Flook, E.P. Mehta, D. Mortimore, S. |
| description | Objectives: The literature reports the merits of antibacterial, antibiotic and steroid agents in treating otological infections but no controlled clinical trial has directly compared 2% glacial acetic acid (EarCalm; Stafford‐Miller Ltd, Brentford, UK) against 2% glacial acetic acid, 0.1% dexamethasone and 3250 U/ml of neomycin sulphate (Otomize; Stafford‐Miller Ltd) in the treatment of otitis externa and infected mastoid cavities.
Design: Prospective, single‐blind randomised controlled trial.
Setting: Outpatients, Derby Royal Infirmary, Derby, UK.
Patients: Emergency and GP referrals with acute otitis externa (n = 53) and infected mastoid cavities (n = 56).
Main outcome measures: Otoscopy was performed at initial randomisation and then at 2 and 4 weeks, the ear assessed for active and inactive disease.
Results: Patients with active otitis externa, 71% (15/21) resolved with glacial acetic acid, dexamethasone and of neomycin sulphate after 2 weeks, increasing to 86% (18/21) after 4 weeks treatment. Patients on glacial acetic acid had only 38% (12/32) resolution after 4 weeks (P |
| doi_str_mv | 10.1111/j.1365-2273.2006.01318.x |
| format | Article |
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Design: Prospective, single‐blind randomised controlled trial.
Setting: Outpatients, Derby Royal Infirmary, Derby, UK.
Patients: Emergency and GP referrals with acute otitis externa (n = 53) and infected mastoid cavities (n = 56).
Main outcome measures: Otoscopy was performed at initial randomisation and then at 2 and 4 weeks, the ear assessed for active and inactive disease.
Results: Patients with active otitis externa, 71% (15/21) resolved with glacial acetic acid, dexamethasone and of neomycin sulphate after 2 weeks, increasing to 86% (18/21) after 4 weeks treatment. Patients on glacial acetic acid had only 38% (12/32) resolution after 4 weeks (P < 0.0005). Two per cent glacial acetic acid, dexamethasone and neomycin sulphate resolved only 30% (8/27) of infected mastoid cavities compared to only 10% (3/29) on glacial acetic acid (P < 0.07). A further 2 weeks treatment this increased to 67%, (18/27) with glacial acetic acid, dexamethasone and neomycin sulphate and 48% (14/29) with glacial acetic acid. These results are not statistically significant.
Conclusion: Glacial acetic acid, dexamethasone and neomycin sulphate is significantly more effective in treating otitis externa when compared with glacial acetic acid. This effect failed to be significant in the infected mastoid cavities group. We therefore recommend that in conjunction with aural toilet, antibiotic/steroid combination is more effective than an antibacterial agent for otitis externa. Larger numbers of infected mastoid cavities are required to be studied.</description><identifier>ISSN: 1749-4478</identifier><identifier>EISSN: 1749-4486</identifier><identifier>DOI: 10.1111/j.1365-2273.2006.01318.x</identifier><identifier>PMID: 17184455</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Acetic Acid - administration & dosage ; Acetic Acid - therapeutic use ; Acute Disease ; Administration, Topical ; Aerosols ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - therapeutic use ; Anti-Inflammatory Agents - administration & dosage ; Anti-Inflammatory Agents - therapeutic use ; Dexamethasone - administration & dosage ; Dexamethasone - therapeutic use ; Drug Therapy, Combination ; Humans ; Mastoiditis - drug therapy ; Mastoiditis - epidemiology ; Neomycin - administration & dosage ; Neomycin - therapeutic use ; Otitis Externa - drug therapy ; Otitis Externa - epidemiology ; Prospective Studies ; Severity of Illness Index ; Single-Blind Method</subject><ispartof>Clinical otolaryngology, 2006-12, Vol.31 (6), p.504-507</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4058-7137940e2c4d6b7fd2cf72b601729b6973e7f7419b90efeaf69561a5e8a3ceaf3</citedby><cites>FETCH-LOGICAL-c4058-7137940e2c4d6b7fd2cf72b601729b6973e7f7419b90efeaf69561a5e8a3ceaf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2273.2006.01318.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2273.2006.01318.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17184455$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnston, M.N.</creatorcontrib><creatorcontrib>Flook, E.P.</creatorcontrib><creatorcontrib>Mehta, D.</creatorcontrib><creatorcontrib>Mortimore, S.</creatorcontrib><title>Prospective randomised single-blind controlled trial of glacial acetic acid versus glacial acetic acid, neomycin sulphate and dexamethasone spray in otitis externa and infected mastoid cavities</title><title>Clinical otolaryngology</title><addtitle>Clin Otolaryngol</addtitle><description>Objectives: The literature reports the merits of antibacterial, antibiotic and steroid agents in treating otological infections but no controlled clinical trial has directly compared 2% glacial acetic acid (EarCalm; Stafford‐Miller Ltd, Brentford, UK) against 2% glacial acetic acid, 0.1% dexamethasone and 3250 U/ml of neomycin sulphate (Otomize; Stafford‐Miller Ltd) in the treatment of otitis externa and infected mastoid cavities.
Design: Prospective, single‐blind randomised controlled trial.
Setting: Outpatients, Derby Royal Infirmary, Derby, UK.
Patients: Emergency and GP referrals with acute otitis externa (n = 53) and infected mastoid cavities (n = 56).
Main outcome measures: Otoscopy was performed at initial randomisation and then at 2 and 4 weeks, the ear assessed for active and inactive disease.
Results: Patients with active otitis externa, 71% (15/21) resolved with glacial acetic acid, dexamethasone and of neomycin sulphate after 2 weeks, increasing to 86% (18/21) after 4 weeks treatment. Patients on glacial acetic acid had only 38% (12/32) resolution after 4 weeks (P < 0.0005). Two per cent glacial acetic acid, dexamethasone and neomycin sulphate resolved only 30% (8/27) of infected mastoid cavities compared to only 10% (3/29) on glacial acetic acid (P < 0.07). A further 2 weeks treatment this increased to 67%, (18/27) with glacial acetic acid, dexamethasone and neomycin sulphate and 48% (14/29) with glacial acetic acid. These results are not statistically significant.
Conclusion: Glacial acetic acid, dexamethasone and neomycin sulphate is significantly more effective in treating otitis externa when compared with glacial acetic acid. This effect failed to be significant in the infected mastoid cavities group. We therefore recommend that in conjunction with aural toilet, antibiotic/steroid combination is more effective than an antibacterial agent for otitis externa. Larger numbers of infected mastoid cavities are required to be studied.</description><subject>Acetic Acid - administration & dosage</subject><subject>Acetic Acid - therapeutic use</subject><subject>Acute Disease</subject><subject>Administration, Topical</subject><subject>Aerosols</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Dexamethasone - administration & dosage</subject><subject>Dexamethasone - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>Humans</subject><subject>Mastoiditis - drug therapy</subject><subject>Mastoiditis - epidemiology</subject><subject>Neomycin - administration & dosage</subject><subject>Neomycin - therapeutic use</subject><subject>Otitis Externa - drug therapy</subject><subject>Otitis Externa - epidemiology</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Single-Blind Method</subject><issn>1749-4478</issn><issn>1749-4486</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAQhiMEoqXwCsgnTiTYsWMnBw7VqhS0FUUI1KPlOJPWixMvtrNkH69vVqe7KhcO-DJj-_tnxv6zDBFckLQ-bApCeZWXpaBFiTEvMKGkLuZn2SkRrMkZq_nzp1zUJ9mrEDYYM4oFeZmdEEFqxqrqNLv_5l3Ygo5mB8irsXODCdChYMZbC3lrzdgh7cbonbXpPHqjLHI9urVKL6nSEI1OwXRoBz5M4V9X79EIbthrM6Iw2e2dioBSM9TBrAaIdyq4EVDYerVHiXHRRBMQzBH8qB5JM_ZpyjTBoEJ0qZlWuwRBeJ296JUN8OYYz7Kfny5-rD7nV9eXX1bnV7lmuKpzQahoGIZSs463ou9K3Yuy5ZiIsml5IyiIXjDStA2GHlTPm4oTVUGtqE5bepa9O9Tdevd7ghBl-ikN1qr0tClIXpdcMCwSWB9Anb42eOjl1ptB-b0kWC72yY1c7JOLfXKxTz7aJ-ckfXvsMbUDdH-FR78S8PEA_DEW9v9dWK6uz5cs6fOD3oQI85Ne-V-SCyoqefP1Ut7Q6jtbr4Vc0weVVr2j</recordid><startdate>200612</startdate><enddate>200612</enddate><creator>Johnston, M.N.</creator><creator>Flook, E.P.</creator><creator>Mehta, D.</creator><creator>Mortimore, S.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200612</creationdate><title>Prospective randomised single-blind controlled trial of glacial acetic acid versus glacial acetic acid, neomycin sulphate and dexamethasone spray in otitis externa and infected mastoid cavities</title><author>Johnston, M.N. ; Flook, E.P. ; Mehta, D. ; Mortimore, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4058-7137940e2c4d6b7fd2cf72b601729b6973e7f7419b90efeaf69561a5e8a3ceaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acetic Acid - administration & dosage</topic><topic>Acetic Acid - therapeutic use</topic><topic>Acute Disease</topic><topic>Administration, Topical</topic><topic>Aerosols</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Dexamethasone - administration & dosage</topic><topic>Dexamethasone - therapeutic use</topic><topic>Drug Therapy, Combination</topic><topic>Humans</topic><topic>Mastoiditis - drug therapy</topic><topic>Mastoiditis - epidemiology</topic><topic>Neomycin - administration & dosage</topic><topic>Neomycin - therapeutic use</topic><topic>Otitis Externa - drug therapy</topic><topic>Otitis Externa - epidemiology</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Single-Blind Method</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnston, M.N.</creatorcontrib><creatorcontrib>Flook, E.P.</creatorcontrib><creatorcontrib>Mehta, D.</creatorcontrib><creatorcontrib>Mortimore, S.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical otolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnston, M.N.</au><au>Flook, E.P.</au><au>Mehta, D.</au><au>Mortimore, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective randomised single-blind controlled trial of glacial acetic acid versus glacial acetic acid, neomycin sulphate and dexamethasone spray in otitis externa and infected mastoid cavities</atitle><jtitle>Clinical otolaryngology</jtitle><addtitle>Clin Otolaryngol</addtitle><date>2006-12</date><risdate>2006</risdate><volume>31</volume><issue>6</issue><spage>504</spage><epage>507</epage><pages>504-507</pages><issn>1749-4478</issn><eissn>1749-4486</eissn><abstract>Objectives: The literature reports the merits of antibacterial, antibiotic and steroid agents in treating otological infections but no controlled clinical trial has directly compared 2% glacial acetic acid (EarCalm; Stafford‐Miller Ltd, Brentford, UK) against 2% glacial acetic acid, 0.1% dexamethasone and 3250 U/ml of neomycin sulphate (Otomize; Stafford‐Miller Ltd) in the treatment of otitis externa and infected mastoid cavities.
Design: Prospective, single‐blind randomised controlled trial.
Setting: Outpatients, Derby Royal Infirmary, Derby, UK.
Patients: Emergency and GP referrals with acute otitis externa (n = 53) and infected mastoid cavities (n = 56).
Main outcome measures: Otoscopy was performed at initial randomisation and then at 2 and 4 weeks, the ear assessed for active and inactive disease.
Results: Patients with active otitis externa, 71% (15/21) resolved with glacial acetic acid, dexamethasone and of neomycin sulphate after 2 weeks, increasing to 86% (18/21) after 4 weeks treatment. Patients on glacial acetic acid had only 38% (12/32) resolution after 4 weeks (P < 0.0005). Two per cent glacial acetic acid, dexamethasone and neomycin sulphate resolved only 30% (8/27) of infected mastoid cavities compared to only 10% (3/29) on glacial acetic acid (P < 0.07). A further 2 weeks treatment this increased to 67%, (18/27) with glacial acetic acid, dexamethasone and neomycin sulphate and 48% (14/29) with glacial acetic acid. These results are not statistically significant.
Conclusion: Glacial acetic acid, dexamethasone and neomycin sulphate is significantly more effective in treating otitis externa when compared with glacial acetic acid. This effect failed to be significant in the infected mastoid cavities group. We therefore recommend that in conjunction with aural toilet, antibiotic/steroid combination is more effective than an antibacterial agent for otitis externa. Larger numbers of infected mastoid cavities are required to be studied.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17184455</pmid><doi>10.1111/j.1365-2273.2006.01318.x</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1749-4478 |
| ispartof | Clinical otolaryngology, 2006-12, Vol.31 (6), p.504-507 |
| issn | 1749-4478 1749-4486 |
| language | eng |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Acetic Acid - administration & dosage Acetic Acid - therapeutic use Acute Disease Administration, Topical Aerosols Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Anti-Inflammatory Agents - administration & dosage Anti-Inflammatory Agents - therapeutic use Dexamethasone - administration & dosage Dexamethasone - therapeutic use Drug Therapy, Combination Humans Mastoiditis - drug therapy Mastoiditis - epidemiology Neomycin - administration & dosage Neomycin - therapeutic use Otitis Externa - drug therapy Otitis Externa - epidemiology Prospective Studies Severity of Illness Index Single-Blind Method |
| title | Prospective randomised single-blind controlled trial of glacial acetic acid versus glacial acetic acid, neomycin sulphate and dexamethasone spray in otitis externa and infected mastoid cavities |
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