Role of Acetic Acid Irrigation in Medical Management of Chronic Suppurative Otitis Media: A Comparative Study

Background: Prior to surgical management of chronic suppurative otitis media (CSOM) for the dry ear medical management is necessary. CSOM is a biofilm disease and due to this has antibiotic resistance. The pillar of its treatment included aural cleaning according to standard protocols, application of topical germ free antiseptic and use of antimicrobials. Acetic acid due to its ability in reducing the pH may be effective in reducing the growth of microorganisms. Objective: The aim of the study was to compare the efficacy of irrigation with acetic acid versus systemic antibiotics in CSOM patients. Materials & Methods: A total of 134 patients, who came to the ENT department of Sheikh Zayed Hospital, Lahore between 1st April 2020 to 30th September 2020, who had CSOM, of age 15 to 55 years and both genders were included in the study. The patients were divided randomly into two groups. Group A patients received aural toilets and irrigation with acetic acid and Group B received 500 mg of ciprofloxacin twice a day for 2 weeks. Results: The mean age (in years) of the patients in Group A was 37.45±7.32 and in Group B, it was 37.96±7.57. The efficacy of irrigation with acetic acid versus systemic antibiotics was 89.55% and 68.66% respectively and this difference between the two groups was found to be statistically significant (p=0.003). Conclusion: Irrigation with acetic acid was better than systemic antibiotics in managing patients with CSOM. Key words: Acetic acid, CSOM, Middle ear

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Role of 1.5% acetic acid irrigation and medical management in chronic persistent suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212124 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1010

Author(s):

Bhavya Kanakarajulu ◽

Lanke Sowmya ◽

Teja .

Keyword(s):

Acetic Acid ◽

Otitis Media ◽

Medical Management ◽

Symptomatic Relief ◽

Tympanic Membrane Perforation ◽

Suppurative Otitis Media ◽

Acid Irrigation ◽

Membrane Perforation ◽

Group 2 ◽

Systemic Antibiotics

Background: Chronic ear discharge in chronic suppurative otitis media (CSOM) persisting for more than two weeks has become difficult to treat for ENT specialists due to resistance to the available antibiotics and patient's affordability for its cost. Also, biofilms have been responsible for the disease and cause tympanic membrane perforation and deafness. The use of 1.5% acetic acid irrigation acts as an antiseptic, and altering the middle ear's pH to treat otorrhea in CSOM needs to be studied. Aim of the study to assess results of 1.5% acetic acid irrigation and topical and systemic antibiotic in CSOM and to consider the most appropriate medical managementMethods: A total of 100 patients of CSOM was divided equally into two groups. Group 1 patients were treated with 1.5% acetic acid irrigation every other day, and group 2 was treated with topical and systemic antibiotics three drops’ times daily. Follow up of both groups every week up to symptomatic relief.Results: Otorrhoea resolution in the group treated with acetic acid was 88%, and healing of perforation was noted in 28 %, while the failure rate of 12%.Conclusions: Medical management of persistent CSOM with tubotympanic type by frequent aural cleaning, 1.5% acetic acid irrigation can be the more desirable choice than the topical and oral antibiotics. It is safe without any side effects and economical. Alteration of ear canal PH is one of the main factors for healing, in addition to mechanical disruption of biofilm and removal of deep-seated debris.

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Quantitative Bacterial Cultures and Beta-Lactamase Activity in Chronic Suppurative Otitis Media

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948909800411 ◽

1989 ◽

Vol 98 (4) ◽

pp. 293-297 ◽

Cited By ~ 32

Author(s):

Itzhak Brook ◽

Paula Yocum

Keyword(s):

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Aerobic Bacteria ◽

Suppurative Otitis Media ◽

Colony Forming Units ◽

Penicillin Therapy ◽

Aerobic And Anaerobic ◽

And Staphylococcus Aureus ◽

Gram Positive Cocci

Aspiration of the exudate through open perforation was performed in 54 children with chronic suppurative otitis media. Eighty aerobic and 81 anaerobic isolates were recovered. Aerobic bacteria only were involved in 20 patients (37%), and anaerobic organisms only in seven (13%). Mixed aerobic and anaerobic isolates were recovered from 27 patients (50%). The most common bacteria isolated were anaerobic gram-positive cocci, Bacteroides melaninogenicus group, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus. There were 45 β-lactamase–producing bacteria (BLPB), 30 aerobes, and 15 anaerobes recovered from 38 patients (70%). β-Lactamase activity was detected in 30 of the 38 ear aspirates (79%) that contained BLPB. All but one of these organisms were in excess of 104 colony-forming units/mL. The detection of β-lactamase activity in the ear aspirates provides evidence of the role of BLPB in the failure of penicillin therapy to eradicate chronic ear infection.

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