A randomised controlled trial of active chronic otitis media comparing courses of eardrops <i>versus</i> one‐off topical treatments suitable for primary, secondary and tertiary healthcare settings

Loock, James

doi:10.1111/j.1749-4486.2012.02532.x

Cited by 33 publications

(35 citation statements)

References 17 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The microbiology associated with otitis media differed from otitis externa, with P. mirabilis (36%) and P. aeruginosa (33%) being the most common isolates, respectively (Table 1). Our results roughly parallel the microbiology pattern reported by Loock [3] at another tertiary hospital in Cape Town in chronic otitis media patients, namely Proteus spp. (29%), P. aeruginosa (24%) and S. aureus (14%) as the most common.…”

Section: Discussionsupporting

confidence: 90%

“…In our study, MRSA was isolated in only 1 patient (1.7%) with otitis media for 2 years; it is not known what treatment the patient had received at primary care facilities. This is similar to the 1.9% incidence of MRSA reported by Loock [3] in patients with chronic active otitis media. These results differ from reports of changing bacteriological spectra and increases in the incidences of S. aureus and MRSA.…”

Section: Discussionsupporting

confidence: 89%

“…However, most ears (in 91 candidates) in this study harboured faecal bacteria, and it was postulated that this finding was due not to bacterial resistance, but due to poor hygiene. [6] In keeping with previous studies, Loock [3] reported that topical quinolone eardrops were effective in the management of active chronic otitis media. Weber et al [11] showed that no significant antibiotic resistance emerged from the use of topical antibiotics.…”

Section: Discussionsupporting

confidence: 67%

See 2 more Smart Citations

Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort

et al. 2013

View full text Add to dashboard Cite

Background. Chronic otorrhoea is difficult to treat, with treatment in South Africa (SA) being protocol driven and generally initiated at the primary healthcare level. There is a lack of local studies that focus on the bacteriology and antimicrobial sensitivities of chronic otorrhoea, which underpins the management advice offered. Aims. To determine the microbiological profile and antimicrobial susceptibility of patients with chronic otorrhoea and the validity of the Department of Health's (DoH) current guideline. Methods. We conducted a prospective study at Groote Schuur Hospital from 2005 to 2009. We included patients with chronic otorrhoea classified as either otitis media or otitis externa, according to our definitions. Pus swabs were taken, from which microorganisms were cultured and tested for antimicrobial susceptibility. Results. Of 79 patients with otorrhoea, 50 had otitis media, 21 had otitis externa and the condition was not determined in 8 patients. The most common organism isolated with otitis media was Proteus mirabilis (18/50; 36%) and with otitis externa, Pseudomonas aeruginosa (7/21; 33%). Otorrhoea had a different microbial spectrum compared with international reports, with methicillin-resistant Staphylococcus aureus infection in a single patient. The organisms isolated were susceptible mainly to fluoroquinolones (96%) and aminoglycosides (81%). Conclusion. Amoxicillin is a poor choice of antibiotic due to its low sensitivity, which calls into question the current DoH guideline for otorrhoea. Antimicrobial treatment protocols should be based on local data and be revisited from time to time. This study suggests that, should first-line treatment fail, an antibiotic with Gram-negative cover, e.g. a topical fluoroquinolone, should be considered.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 67%

See 1 more Smart Citation

Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort

et al. 2013

View full text Add to dashboard Cite

show abstract

“…This lack of effectiveness of acetic acid has been documented in a recent SA study. [21] CSOM is a condition occurring mainly in patients of low socioeconomic status, [2,12,18] who may not have access to clean water. Exposure of the auditory canals to contaminated water has been identified as a risk factor for CSOM.…”

Section: Discussionmentioning

confidence: 99%

Paediatric chronic suppurative otitis media in the Free State Province: Clinical and audiological features

et al. 2013

View full text Add to dashboard Cite

Background. Chronic suppurative otitis media (CSOM) is a chronic infection of the middle ear cleft. In sub-Saharan Africa >50% of cases occur in children <10 years of age. Objectives. To describe the otological, audiological and bacteriological findings in children with CSOM. Methods. We conducted a prospective study at the Ear, Nose and Throat (ENT) Clinic at Universitas Academic Hospital between August 2009 and December 2010. We included all children with CSOM over this period. Patients underwent ENT and paediatric examination, and were tested for HIV. Pus swabs were taken after an ear toilet for routine microbiology, fungal and Mycobacterium tuberculosis culture. We performed audiological testing after the otorrhoea had resolved. Results. Eighty-six children (113 ears) were included, with a median age of 4.6 years (range 1 -12 years). The mean duration of otorrhoea was 161.7 weeks (range 4 -572 weeks). Nine patients (10.5%) presented with coalescent mastoiditis and/or intracranial complications of CSOM. Of the 153 organisms identified, Gram-negative bacteria were present in 93 (82.3%) ears, with 94.8% of these being sensitive to quinolones. Only 1 case of tuberculous otitis media was identified. HIV infection was present in 54.6% of patients tested. There was a hearing loss in 44 (66.7%) of the tested affected ears. Conclusions. There was a long delay between the onset of symptoms and accessing ENT services. Most cases of CSOM were due to quinolone-sensitive Gram-negative aerobes. There was a high prevalence of cholesteatoma, hearing loss and other complications in children in this study.

show abstract

“…In children who suffer associated hearing loss this delay has a negative impact on school performance. [14] In addition, Loock [16] and the aforementioned two local ENT departments investigated the microbial spectrum of otorrhoea in their respective communities. [14][15][16][17] All of the local studies have identified Proteus mirabilis and Pseudomonas aeruginosa as the most prevalent pathogens.…”

mentioning

confidence: 99%

Otorhinolaryngology – not just tonsils and grommets: Insights into the ENT scene in South Africa

Peer

2013

S Afr Med J

View full text Add to dashboard Cite

A randomised controlled trial of active chronic otitis media comparing courses of eardrops versus one‐off topical treatments suitable for primary, secondary and tertiary healthcare settings

Cited by 33 publications

References 17 publications

Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort

Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort

Paediatric chronic suppurative otitis media in the Free State Province: Clinical and audiological features

Otorhinolaryngology – not just tonsils and grommets: Insights into the ENT scene in South Africa

Contact Info

Product

Resources

About