topical antibiotics and chronic suppurative otitis media (CSOM)

Last edited 08/2020 and last reviewed 03/2022

• chronic suppurative otitis media (CSOM) is an infection of the middle ear with pus and a persistent perforation in the eardrum. It is a common cause of preventable hearing impairment
• a systematic review found that:
  • uncertain about the effectiveness of topical antibiotics in improving resolution of ear discharge in patients with CSOM because of the limited amount of low-quality evidence available
  • some evidence to suggest that the use of topical antibiotics may be effective when compared to placebo, or when used in addition to a systemic antibiotic
  • uncertainty about the relative effectiveness of different types of antibiotics; it is not possible to determine with any certainty whether or not quinolones are better or worse than aminoglycosides. These two groups of compounds have different adverse effect profiles, but there is insufficient evidence from the included studies to make any comment about these. In general, adverse effects were poorly reported

Reference:

• Brennan-Jones CG et al. Topical antibiotics for chronic suppurative otitis media. Cochrane Syst Reviews January 2020