Prophylactic antibiotic drops after tympanostomy tube placement

• Published in: Archives of otolaryngology--head & neck surgery Vol. 121; no. 4; p. 445
• Main Authors: Hester, T O, Jones, R O, Archer, S M, Haydon, R C
• Format: Journal Article
• Language: English
• Published: United States 01-04-1995
• Subjects: Child; Child, Preschool; Drug Combinations; Humans; Hydrocortisone - therapeutic use; Infant; Instillation, Drug; Middle Ear Ventilation; Neomycin - therapeutic use; Otitis Media - surgery; Otitis Media with Effusion - prevention & control; Polymyxin B - therapeutic use; Postoperative Complications - prevention & control; Prospective Studies; Treatment Outcome
• ISSN: 0886-4470
• DOI: 10.1001/archotol.1995.01890040069011

To evaluate the effectiveness of prophylactic polymyxin B sulfate-neomycin sulfate-hydrocortisone drops in decreasing the incidence of posttympanostomy otorrhea.
Prospective randomized controlled study.
University referral center.
Three hundred patients undergoing tympanostomy tube placement (including those undergoing tonsillectomy, adenoidectomy, or both) were randomized into three groups.
The use of polymyxin B-neomycin-hydrocortisone drops. Patients in group 1 received no antibiotic drops; group 2, a single dose intraoperatively, and group 3, an intraoperative dose followed by a 5-day course.
Posttympanostomy otorrhea.
A statistically significant decrease was observed in the incidence of posttympanostomy otorrhea between the control (16.4%) and treatment groups (group 2, 8.3%; group 3, 8.1%) (P = .011). A single dose of antibiotics was effective when patients' middle ears were dry or had serous effusions. A 5-day course was indicated for those whose ears had mucoid or purulent contents.
Antibiotic ear drops are indicated in all patients. A single dose is as effective as a 5-day course, but our data support a longer course in certain subgroups.