Skip to main content
Log in

In vitro efficacy of the successive or staggered use of eardrops

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology and Head & Neck Aims and scope Submit manuscript

Abstract

Chronic suppurative otitis media is still a significant health problem. Several topical agents such as antibacterials, steroids and acid media eardrops are widely used alone or in combination to control active otorrhea and obtain a dry ear. Patients frequently ask if there is any benefit or loss in the effect of these due to their use in a successive or staggered manner. This question led us to design this in vitro study to investigate the effect of the acetic acid solution and dexamethasone sodium phosphate on the antimicrobial effects of some ototopical antibiotics during their successive or staggered usage. Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis and Escherichia coli were used for testing the antimicrobial activities of the selected antibiotic drops. Six microliters of acetic acid solution and dexamethasone sodium phosphate were used alone or together with 6 µl each of ciprofloxacin HCl, tobramycin and ofloxacin solution. Drops were placed on Whatman no. 1 paper disks with a diameter of 6 mm, and the disks were placed onto Mueller-Hinton agar plates on which bacteria had been swabbed over the entire surface. After overnight incubation of the plates at 35°C, the diameters of the inhibition zones were recorded. There was no antibacterial effect in response to either acid solution or dexamethasone used alone. The inhibition zones of the antibiotics did not change with either steroid or acid media solution added onto the antibiotic disks alone or together. Acid solution or steroids should be preferred to use in combination with antibacterial otic drugs in in-vivo settings; no negative or positive effects were seen in in-vitro conditions. Therefore, prescribed eardrops can be used in a successive or staggered manner without any influence on the treatment results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Alper CM, Dohar JE, Gulhan M, Ozunlu A, Bagger-Sjobak D, Hebda PA, Swarts JD (2000) Treatment of chronic suppurative otitis media with topical tobramycin and dexamethasone. Arch Otolaryngol Head Neck Surg 126:165–173

    PubMed  Google Scholar 

  2. Aminifarshidmehr N (1996) The management of chronic suppurative otitis media with acid media solution. Am J Otol 17:24–25

    PubMed  Google Scholar 

  3. Black A, Redmond AO, Steen HJ, Oborska IT (1990) Tolerance and safety of ciprofloxacin in paediatric patients. J Antimicrob Chemother 26 [Suppl F]:25–29

  4. Bluestone CD, Klein JO (1999) Consultation with the specialist: chronic suppurative otitis media. Pediatr Rev 20:277–279

    PubMed  Google Scholar 

  5. Chysky V, Kapila K, Hullmann R, Arcieri G, Schacht P, Echols R (1991) Safety of ciprofloxacin in children: worldwide clinical experience based on compassionate use. Emphasis on joint evaluation. Infection 19:289–296

    Article  PubMed  Google Scholar 

  6. Dohar JE, Alper CM, Rose EA, Doyle WJ, Casselbrant ML, Kenna MA, Bluestone CD (1998) Treatment of chronic suppurative otitis media with topical ciprofloxacin. Ann Otol Rhinol Laryngol 107:865–871

    PubMed  Google Scholar 

  7. Eady EA, Cove JH (1990) Topical antibiotic therapy: current status and future prospects. Drugs Exp Clin Res 16:423–433

    PubMed  Google Scholar 

  8. Eason RJ, Harding E, Nicholson R, Nicholson D, Pada J, Gathercole J (1986) Chronic suppurative otitis media in the Solomon Islands: a prospective, microbiological, audiometric and therapeutic survey. N Z Med J 99:812–815

    PubMed  Google Scholar 

  9. Erkan M, Aslan T, Sevuk E, Guney E (1994) Bacteriology of chronic suppurative otitis media. Ann Otol Rhinol Laryngol 103:771–774

    PubMed  Google Scholar 

  10. Esposito S, Noviello S, D’Errico G, Montanaro C (1992) Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media. Arch Otolaryngol Head Neck Surg 118:842–844

    Google Scholar 

  11. Fombeur JP, Barrault S, Koubbi G, Laurier JN, Ebbo D, Lecomte F, Sorrel N, Dobler S (1994) Study on the efficacy and safety of ciprofloxacin in the treatment of chronic otitis. Chemotherapy 40 [Suppl 1]:29–34

    Google Scholar 

  12. Fradis M, Brodsky A, Ben-David J, Srugo I, Larboni J, Podoshin L (1997) Chronic otitis media treated topically with ciprofloxacin or tobramycin. Arch Otolaryngol Head Neck Surg 123:1057–1060

    PubMed  Google Scholar 

  13. Gates GA (2001) Safety of ofloxacin otic and other ototopical treatment in animal models and in humans. Pediatr Infect Dis J 20:104–107

    PubMed  Google Scholar 

  14. Hannley MT, Denneny JC 3rd, Holzer SS (2000) Use of ototopical antibiotics in treating three common ear diseases. Otolaryngol Head Neck Surg 122:934–940

    Article  PubMed  Google Scholar 

  15. Kaygusuz I, Karlidag T, Gok U, Yalcin S, Keles E, Demirbag E, Kaygusuz TO (2002) Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media. Kulak Burun Boğaz Ihtis Derg 9:106–111

    Google Scholar 

  16. Khanna V, Chander J, Nagarkar NM, Dass A (2000) Clinicomicrobiologic evaluation of active tubotympanic type chronic suppurative otitis media. J Otolaryngol 29:148–153

    PubMed  Google Scholar 

  17. Kiris M, Berktas M, Egeli E, Kutluhan A (1998) The efficacy of topical ciprofloxacin in the treatment of chronic suppurative otitis media. Ear Nose Throat J 77:904–905, 909

    PubMed  Google Scholar 

  18. Klein JO (2001) In vitro and in vivo antimicrobial activity of topical ofloxacin and other ototopical agents. Pediatr Infect Dis J 20:102–103

    PubMed  Google Scholar 

  19. Lundy LB, Graham MD (1993) Ototoxicity and ototopical medications: a survey of otolaryngologists. Am J Otol 14:141–146

    PubMed  Google Scholar 

  20. Miro N (2000) Controlled multicenter study on chronic suppurative otitis media treated with topical applications of ciprofloxacin 0.2% solution in single-dose containers or combination of polymixin B, neomycin, and hydrocortisone suspension. Otolaryngol Head Neck Surg 123:617–623

    Article  PubMed  Google Scholar 

  21. National Committee for Clinical Laboratory Standards, Performance Standarts for Antimicrobial Susceptibility testing, Twelfth informational supplement (2002) NCCLS document M100-S12, Wayne, Pennsylvania

  22. Nelson JD (1988) Management of CSOM: a survey of practicing pediatricians. Ann Otol Rhinol Laryngol 97 [Suppl 131]:26–28

  23. Neu HC, Chin NX (1989) In vitro activity of S-ofloxacin. Antimicrob Agents Chemother 33:1105–1107

    PubMed  Google Scholar 

  24. Rang HP, Dale MM, Ritter JM (1999) Antibacterial drugs. In: Rang HP, Dole MM, Ritter JM (eds) Pharmacology, 4th edn. Churchill Livingstone, Edinburgh, pp 685–707

  25. Roland PS, Anon JB, Moe RD, Conroy PJ, Wall GM, Dupre SJ, Krueger KA, Potts S, Hogg G, Stroman DW (2003) Topical ciprofloxacin/dexamethasone is superior to ciprofloxacin alone in pediatric patients with acute otitis media and otorrhea through tympanostomy tubes. Laryngoscope 113:2116–2122

    Article  PubMed  Google Scholar 

  26. Simpson KL, Markham A (1999) Ofloxacin otic solution: a review of its use in the management of ear infections. Drugs 58:509–531

    PubMed  Google Scholar 

  27. Tong MC, Woo JK, van Hasselt CA (1996) A double-blind comparative study of ofloxacin otic drops versus neomycin-polymyxin B-hydrocortisone otic drops in medical treatment of chronic suppurative otitis media. J Laryngol Otol 110:309–314

    PubMed  Google Scholar 

  28. Tutkun A, Ozagar A, Koc A, Batman C, Uneri C, Sehitoglu MA (1995) Treatment of chronic ear disease: topical ciprofloxacin vs topical gentamicin. Arch Otolaryngol Head Neck Surg 121:1414–1416

    PubMed  Google Scholar 

  29. Vartiainen E, Vartiainen J (1996) Effect of aerobic bacteriology on the clinical presentation and treatment results of chronic suppurative otitis media. J Laryngol Otol 110:315–318

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Tayyar Kalcioglu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kalcioglu, M.T., Ozturan, O., Durmaz, R. et al. In vitro efficacy of the successive or staggered use of eardrops. Eur Arch Otorhinolaryngol 263, 395–398 (2006). https://doi.org/10.1007/s00405-005-1014-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-005-1014-2

Keywords

Navigation