A clinical comparison of hydrocortisone butyrate with oxytetracycline/hydrocortisone acetate -polymyxin B in the local treatment of acute external otitis

1990 ◽  
Vol 247 (2) ◽  
Author(s):  
M. Ruth ◽  
T. Ekstr�m ◽  
B. �berg ◽  
S. Edstr�m
Keyword(s):  
Local Treatment ◽  
Polymyxin B ◽  
External Otitis ◽  
Hydrocortisone Acetate ◽  
Hydrocortisone Butyrate ◽  
Clinical Comparison

PD58 Cost-Effectiveness Of Quinolone For Acute External Otitis In Brazil

2018 ◽  
Vol 34 (S1) ◽  
pp. 150-150
Author(s):  
Gustavo de Oliveira ◽  
Camila Chacarolli ◽  
Sarah Silva ◽  
Artur Felipe de Brito
Keyword(s):  
Cost Effectiveness ◽  
Clinical Outcomes ◽  
Treatment Effectiveness ◽  
Low Cost ◽  
Cost Effective ◽  
Polymyxin B ◽  
External Otitis ◽  
Cochrane Library ◽  
Effectiveness Model ◽  
Life Years

Introduction:In Brazil, the medicines marketed for acute external otitis are ciprofloxacin and the combination polymyxin B, neomycin, and fluocinolone. The aim of this study was to evaluate the proportion of cure and cost-effectiveness of quinolone versus polymyxin B, neomycin, and steroid combined (PNS) for acute external otitis from the perspective of the Brazilian Public health system.Methods:A systematic review was conducted using Medline, Cochrane Library, CRD and Lilacs databases. Studies evaluating quinolones versus PNS in the treatment of acute external otitis were included. A cost-effectiveness model was made using a decision tree, considering the direct cost of treatment. Univariate sensitivity analysis was conducted, considering the confidence interval of clinical outcomes and a 15 percent variation in cost.Results:The proportion of cure in up to 10 days was 70.1 percent with quinolone and 60.4 percent with PNS (p = 0.004). The treatment costs were BRL 16.22 (USD 5.02) with quinolone and BRL 3.04 (USD 0.94) with PNS. The incremental cost-effectiveness ratio was BRL 136.25 (USD 42.15) per cure in up to 10 days for quinolone in relation to PNS. This value was more sensitive to clinical outcomes, ranging from BRL 95.48 (USD 29.54) to BRL 254.25 (USD 78.65) for cure with quinolone and from BRL 90.77 (USD 28.08) to BRL 262.57 (USD 81.23) for cure with PNS. These values should be considered with caution because acute external otitis is resolved within a few days and treatment effectiveness is not measured by life years.Conclusions:There are few studies on therapeutic alternatives available in Brazil. Through the available evidence, there is a lack of results on the effects attributed to each drug. Considering the higher effectiveness, low cost and rational use of antibiotics, quinolone is considered a cost-effective alternative for acute external otitis in Brazil.

A group III steroid solution without antibiotic components: an effective cure for external otitis

2005 ◽  
Vol 119 (5) ◽  
pp. 342-347 ◽  
Author(s):  
Per Emgård ◽  
Sten Hellström
Keyword(s):  
Acute Phase ◽  
Polymyxin B ◽  
External Otitis ◽  
Serious Adverse Events ◽  
Group Iii ◽  
Treatment Groups ◽  
Parallel Group ◽  
Clinical Benefits ◽  
Ear Canals ◽  
Ear Drops

The present study was undertaken to compare the clinical benefits of prescribing ear drops containing 0.05% solution of betamethasone dipropionate (BD), and ear drops containing hydrocortisone with oxytetracycline hydrochloride and polymyxin B (HCPB), for topical treatment of external otitis.Fifty-one patients were enrolled in this open randomized, parallel-group, multicentre study,performed in eight different ENT departments. The patients were randomly assigned to one of thetwo treatment groups: BD (n= 26) and HCPB (n= 25). Only ENT specialists investigated the patients. Bacterial and fungal cultures were raised on days 1 and 11, using swabbedmaterial from ear canals. Twice daily the patients recorded their symptoms during the acute phase, using special diary cards.BD proved a significantly more effective cure than HCPB during the acute phase of external otitis and afforded a lower relapse frequency during a six-month follow-up period. The patients of the BD group were significantly less troubled by itching (p <0.01) than those in the HCPB group. On day 11, at the end of the acute phase, growth of bacteria (p= 0.03) and fungi (p < 0.01) was less frequent in the BD group than inthe HCPB group. No serious adverse events occurred, and those minor events observed were comparable between the two groups.Our conclusion is that the group III steroid solution, BD, cured the external otitismore effectively than did the HCPB solution, whether infected by bacteria or by fungi. No difference was evident regarding adverse effects. Furthermore, price favours a solution without any antibiotic component. In view of these observations, a group III steroid solution ought to be the preferred remedy for external otitis, whether infected or not.

Ototoxicity of ear drops in patients suffering from chronic otitis media

1989 ◽  
Vol 103 (1) ◽  
pp. 46-50 ◽  
Author(s):  
L. Podoshin ◽  
M. Fradis ◽  
J. Ben David
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otitis Media ◽  
Medical Center ◽  
Local Treatment ◽  
Chronic Otitis Media ◽  
Polymyxin B ◽  
Sensorineural Hearing ◽  
Control Group ◽  
Ear Drops

AbstractThe sensorineural hearing loss in 150 patients with chronic otitis media who were treated in the Haifa Medical Center (Rothschild) during a ten year period was studied. There were 124 patients treated with a mixture containing neomycin, polymyxin B and dexamethasone and a control group of 26 patients with dexamethasone only.All patients were followed up for a period of 1–2 years. Patients with hearing loss due to factors such as previous ear surgery, family history, exposure to noise etc., have been excluded.The conclusions reached were that there is a relationship between the period of disease and the sensorineural hearing loss and that the local treatment with a mixture containing neomycin + polymyxin B appears to contribute to the worsening of the sensorineural hearing loss in patients with chronic otitis media.Our numbers are small and further studies must be done, but the fact that currently used ear drops may produce a sensorineural hearing loss should not be ignored.

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