A meta-analysis of the efficacy of quinolone containing otics in comparison to antibiotic–steroid combination drugs in the local treatment of otitis externa

Mösges, Ralph; Nematian-Samani, Mehregan; Hellmich, Martin; Shah‐Hosseini, Kija

doi:10.1185/03007995.2011.616192

Cited by 18 publications

(14 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Topical use of antibiotics for treating otitis cases is a common practices followed by practioners. Mosges et al (2011) stated that fluroquinolones had high success rate than non-quinolones in curing the otitis. Enrofloxacin is a drug of choice against Staphylococci in the recurrent and chronic skin problems in our local area (Reddy et al, 2014b).…”

Section: Treatment and Discussionmentioning

confidence: 99%

Chronic Dermatitis Complicated with Otitis Due to Notoedres cati in a Persian Cat

Sivajothi¹

2015

J. adv. parasitol.

View full text Add to dashboard Cite

| Notoedres cati is one of the most common mites causing dermatitis in cats. Otitis along with generalised dermatitis was observed in an eight months Persian cat. Cat had history of head shaking, intense pruritus, alopecic and erythematous areas on the ears. The skin at the lesion area was scrapped and examined under a light microscope. Notoedres mites were observed in otic discharges and skin scrapings. It was treated with doramectin at weekly intervals, ciprofloxacin otic drops daily twice for five days. After therapy, marked improvement was noticed and by re-growth of hair over the affected region within 14 days.

show abstract

Section: Treatment and Discussionmentioning

confidence: 99%

Chronic Dermatitis Complicated with Otitis Due to Notoedres cati in a Persian Cat

Sivajothi¹

2015

J. adv. parasitol.

View full text Add to dashboard Cite

show abstract

“…Safety profiles were similar between groups. 40 Similarly, Mösges et al 42 reviewed 12 relevant randomized controlled clinical studies involving 2682 patients and concluded that quinolone therapy achieved a higher cure rate (P = .01) and superior eradication rate (P = .03) than a non-fluoroquinolone-containing antibiotic-steroid combination. The clinical significance of these 2 reviews is reduced, however, when considering that bacterial persistence in the ear canal after treatment does not necessarily imply persistent acute otitis externa symptoms.…”

Section: External Otitis Tympanostomy Tubeassociated Otorrheamentioning

confidence: 99%

The Use of Systemic and Topical Fluoroquinolones

Jackson¹,

Schutze²

2016

Pediatrics

143

View full text Add to dashboard Cite

Appropriate prescribing practices for fluoroquinolones, as well as all antimicrobial agents, are essential as evolving resistance patterns are considered, additional treatment indications are identified, and the toxicity profile of fluoroquinolones in children has become better defined. Earlier recommendations for systemic therapy remain; expanded uses of fluoroquinolones for the treatment of certain infections are outlined in this report. Prescribing clinicians should be aware of specific adverse reactions associated with fluoroquinolones, and their use in children should continue to be limited to the treatment of infections for which no safe and effective alternative exists or in situations in which oral fluoroquinolone treatment represents a reasonable alternative to parenteral antimicrobial therapy.

show abstract

“…Kaushik and coworkers 110 reached the same conclusion in their more recent Cochrane review, which included 7 newer trials with more than 1600 patients. In contrast, Mösges and colleagues 129 found superior clinical cure rates for topical quinolones versus other antibiotic-steroid combination drugs (odds ratio, 1.29; 95% CI, 1.06-1.57). However, the validity of this finding must take into consideration industry funding, substantial heterogeneity in the pooled analysis, and the possibility of a trivial effect size as suggested by the lower bound of the 95% CI (near unity).…”

Section: Efficacy Of Topical Therapymentioning

confidence: 95%

“…The clinical significance of this modest effect (NNT of 12 patients) is reduced when considering that persistent bacteria in the ear canal after treatment does not necessarily imply persistent AOE symptoms. Mösges and colleagues 129 also found a higher bacteriologic cure rate when quinolones were used (odds ratio, 1.44; 95% CI, 1.03-2.02). The validity of this finding, however, must again take into consideration industry funding, substantial heterogeneity in the pooled analysis, and possibility of a trivial effect size as suggested by the lower bound of the 95% CI (near unity).…”

Section: Efficacy Of Topical Therapymentioning

confidence: 98%

“…129 Although these 3 meta-analyses differ in study design, trial selection, and methods of statistical pooling, they all conclude that topical therapy is highly effective first-line therapy for diffuse AOE. Similarly, they do not find any meaningful differences in clinical outcomes based on class of drug (antibiotic vs antiseptic), use of a quinolone versus a nonquinolone preparation, or for monotherapy versus combination drugs with or without a concurrent steroid.…”

Section: Efficacy Of Topical Therapymentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guideline: Acute Otitis Externa

Rosenfeld

Schwartz

Cannon

et al. 2014

Otolaryngol.--head neck surg.

134

View full text Add to dashboard Cite

Objective. This clinical practice guideline is an update and replacement for an earlier guideline published in 2006 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation. This update provides evidence-based recommendations to manage acute otitis externa (AOE), defined as diffuse inflammation of the external ear canal, which may also involve the pinna or tympanic membrane. The variations in management of AOE and the importance of accurate diagnosis suggest a need for updating the clinical practice guideline. The primary outcome considered in this guideline is clinical resolution of AOE.Purpose. The primary purpose of the original guideline was to promote appropriate use of oral and topical antimicrobials for AOE and to highlight the need for adequate pain relief. An updated guideline is needed because of new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group. The target patient is aged 2 years or older with diffuse AOE. Differential diagnosis will be discussed, but recommendations for management will be limited to diffuse AOE, which is almost exclusively a bacterial infection. This guideline is intended for primary care and specialist clinicians, including otolaryngologists-head and neck surgeons, pediatricians, family physicians, emergency physicians, internists, nurse practitioners, and physician assistants. This guideline is applicable in any setting in which patients with diffuse AOE would be identified, monitored, or managed.Action Statements. The development group made strong recommendations that (1) clinicians should assess patients with AOE for pain and recommend analgesic treatment based on the severity of pain and (2) clinicians should not prescribe systemic antimicrobials as initial therapy for diffuse, uncomplicated AOE unless there is extension outside the ear canal or the presence of specific host factors that would indicate a need for systemic therapy. The development group made recommendations that (1) clinicians should distinguish diffuse AOE from other causes of otalgia, otorrhea, and inflammation of the external ear canal; (2) clinicians should assess the patient with diffuse AOE for factors that modify management (nonintact tympanic membrane, tympanostomy tube, diabetes, immunocompromised state, prior radiotherapy); (3) clinicians should prescribe topical preparations for initial therapy of diffuse, uncomplicated AOE; (4) clinicians should enhance the delivery of topical drops by informing the patient how to administer topical drops and by performing aural toilet, placing a wick, or both, when the ear canal is obstructed; (5) clinicians should prescribe a non-ototoxic preparation when the patient has a known or suspected perforation of the tympanic membrane, including a tympanostomy tube; and (6) clinicians should reassess the patient who fails to respond to the initial therapeutic option within 48 to 72 hours to confirm the diagnosis of diffuse AOE and to exclude other causes of illness. Keyw...

show abstract

A meta-analysis of the efficacy of quinolone containing otics in comparison to antibiotic–steroid combination drugs in the local treatment of otitis externa

Abstract: With a level Ia evidence, this investigation validates the clinical benefit of quinolones as compared to classic combination drugs in the local treatment of acute otitis externa.

Cited by 18 publications

References 28 publications

Chronic Dermatitis Complicated with Otitis Due to Notoedres cati in a Persian Cat

Chronic Dermatitis Complicated with Otitis Due to Notoedres cati in a Persian Cat

The Use of Systemic and Topical Fluoroquinolones

Clinical Practice Guideline: Acute Otitis Externa

Contact Info

Product

Resources

About