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Meta-Analysis
. 2020 Jan 2;1(1):CD013051.
doi: 10.1002/14651858.CD013051.pub2.

Topical antibiotics for chronic suppurative otitis media

Christopher G Brennan-Jones  1 , Karen Head  2 , Lee-Yee Chong  2 , Martin J Burton  3 , Anne Gm Schilder  4 , Mahmood F Bhutta  5
Affiliations
Meta-Analysis

Topical antibiotics for chronic suppurative otitis media

Christopher G Brennan-Jones et al. Cochrane Database Syst Rev. .

Update in

  • Topical antibiotics for chronic suppurative otitis media.
    Brennan-Jones CG, Head K, Chong LY, Daw J, Veselinović T, Schilder AG, Bhutta MF. Brennan-Jones CG, et al. Cochrane Database Syst Rev. 2025 Jun 9;6(6):CD013051. doi: 10.1002/14651858.CD013051.pub3. Cochrane Database Syst Rev. 2025. PMID: 40484407

Abstract

Background: Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection (involving more than one micro-organism) of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Topical antibiotics, the most common treatment for CSOM, act to kill or inhibit the growth of micro-organisms that may be responsible for the infection. Antibiotics can be used alone or in addition to other treatments for CSOM, such as antiseptics or ear cleaning (aural toileting).

Objectives: To assess the effects of topical antibiotics (without steroids) for people with CSOM.

Search methods: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL via the Cochrane Register of Studies); Ovid MEDLINE; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 1 April 2019.

Selection criteria: We included randomised controlled trials (RCTs) with at least a one-week follow-up involving participants (adults and children) who had chronic ear discharge of unknown cause or CSOM, where the ear discharge had continued for more than two weeks. The interventions were any single, or combination of, topical antibiotic agent(s) of any class, applied directly into the ear canal as ear drops, powders or irrigations, or as part of an aural toileting procedure. The two main comparisons were topical antibiotic compared to a) placebo or no intervention and b) another topical antibiotic (e.g. topical antibiotic A versus topical antibiotic B). Within each comparison we separated studies where both groups of participants had received topical antibiotic a) alone or with aural toileting and b) on top of background treatment (such as systemic antibiotics).

Data collection and analysis: We used the standard Cochrane methodological procedures. We used GRADE to assess the certainty of the evidence for each outcome. Our primary outcomes were: resolution of ear discharge or 'dry ear' (whether otoscopically confirmed or not), measured at between one week and up to two weeks, two weeks to up to four weeks and after four weeks; health-related quality of life using a validated instrument; ear pain (otalgia) or discomfort or local irritation. Secondary outcomes included hearing, serious complications and ototoxicity measured in several ways.

Main results: We included 17 studies with a total of 2198 participants. Twelve studies reported the sample size in terms of participants (not ears); these had a total of 1797 participants. The remaining five studies reported both the number of participants and ears, representing 401 participants, or 510 ears. A: Topical antibiotics versus placebo or no treatment (with aural toilet in both arms and no other background treatment) One small study compared a topical antibiotic (ciprofloxacin) with placebo (saline). All participants received aural toilet. Although ciprofloxacin was better than saline in terms of resolution of discharge at one to two weeks: 84% versus 12% (risk ratio (RR) 6.74, 95% confidence interval (CI) 1.82 to 24.99; 35 participants, very low-certainty evidence), the very low certainty of the evidence means that it is very uncertain whether or not one intervention is better or worse than the other. The study authors reported that "no medical side-effects and worsening of audiological measurements related to this topical medication were detected" (very low-certainty evidence). B: Topical antibiotics versus placebo or no treatment (with use of oral antibiotics in both arms) Four studies compared topical ciprofloxacin to no treatment (three studies; 190 participants) or topical ceftizoxime to no treatment (one study; 248 participants). In each study all participants received the same antibiotic systemically (oral ciprofloxacin, injected ceftizoxime). In at least one study all participants received aural toilet. Useable data were only available from the first three studies; ciprofloxacin was better than no treatment, resolution of discharge occurring in 88.2% versus 60% at one to two weeks (RR 1.47, 95% CI 1.20 to 1.80; 2 studies, 150 participants; low-certainty evidence). None of the studies reported ear pain or discomfort/local irritation. C: Comparisons of different topical antibiotics The certainty of evidence for all outcomes in these comparisons is very low. Quinolones versus aminoglycosides Seven studies compared an aminoglycoside (gentamicin, neomycin or tobramycin) with ciprofloxacin (734 participants) or ofloxacin (214 participants). Whilst resolution of discharge at one to two weeks was higher in the quinolones group the very low certainty of the evidence means that it is very uncertain whether or not one intervention is better or worse than the other (RR 1.95, 95% CI 0.88 to 4.29; 6 studies, 694 participants). One study measured ear pain and reported no difference between the groups. Quinolones versus aminoglycosides/polymyxin B combination ±gramicidin We identified three studies but data on our primary outcome were only available in one study. Comparing ciprofloxacin to a neomycin/polymyxin B/gramicidin combination, for an unknown treatment duration (likely four weeks), ciprofloxacin was better (RR 1.12, 95% CI 1.03 to 1.22, 186 participants). A "few" patients experienced local irritation upon the first instillation of topical treatment (numbers/groups not stated). Others Other studies examined topical gentamicin versus a trimethoprim/sulphacetamide/polymixin B combination (91 participants) and rifampicin versus chloramphenicol (160 participants). Limited data were available and the findings were very uncertain.

Authors' conclusions: We are 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. However, amongst this uncertainty there is 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. There is also 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.

PubMed Disclaimer

Conflict of interest statement

Christopher G Brennan‐Jones: Dr Brennan‐Jones's research team is primarily funded by the Australian NHMRC and the WA Department of Health. He sits on the national Technical Advisory Group responsible for developing treatment guidelines for otitis media in Australia.

Karen Head: none known.

Lee Yee Chong: none known.

Martin J Burton: Professor Martin Burton is joint Co‐ordinating Editor of Cochrane ENT, but had no role in the editorial process for this review.

Anne GM Schilder: Professor Anne Schilder is joint Co‐ordinating Editor of Cochrane ENT, but had no role in the editorial process for this review. Her evidENT team at UCL is supported in part by the National Institute of Health Research (NIHR) University College London Hospitals Biomedical Research Centre. The research is funded by the NIHR and EU Horizon2020. She is the national chair of the NIHR Clinical Research Network ENT Specialty. She is the Surgical Specialty Lead for ENT for the Royal College of Surgeons of England's Clinical Trials Initiative. In her role as director of the NIHR UCLH BRC Deafness and Hearing Problems Theme, she acts as an advisor on clinical trial design and delivery to a range of biotech companies, most currently Novus Therapeutics.

Mahmood F Bhutta: Dr Mahmood Bhutta has received an honorarium from Novus Therapeutics for advice on an experimental treatment for otitis media (not related to any treatment in this review).

Figures

1
1
Study flow diagram
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Topical ciprofloxacin versus placebo (aural toileting in both arms), Outcome 1 Resolution of ear discharge.
2.1
2.1. Analysis
Comparison 2 Topical ciprofloxacin added on to oral ciprofloxacin, Outcome 1 Resolution of ear discharge.
3.1
3.1. Analysis
Comparison 3 Quinolones versus others, Outcome 1 Resolution of ear discharge (1 to 2 weeks).
3.2
3.2. Analysis
Comparison 3 Quinolones versus others, Outcome 2 Resolution of ear discharge (2 to 4 weeks).
4.1
4.1. Analysis
Comparison 4 Rifampicin versus chloramphenicol, Outcome 1 Resolution of ear discharge (1 to 2 weeks).
See this image and copyright information in PMC

References

References to studies included in this review

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Dohar 2002 {published data only}
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Esposito 2000 {published data only}
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Fliss 1990 {published data only}
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Fombeur 1994 {published data only}
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Fraysse 1988 {published data only}
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Garcia‐Rodriguez 1993 {published data only}
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Gehanno 1997 {published data only}
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Gendeh 2001 {published data only}
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    1. Gendeh S. A comparative study of ofloxacin otic drops vs. framycetin sulfate‐dexamethasone‐gramicidin otic drops in the medical treatment of otitis externa and chronic suppurative otitis media. Department of ORL, Hospital University Kabangsaan Malaysia, Kuala Lumpur, Malaysia Unpublished, 2000.
Ghosh 2012 {published data only}
    1. CTRI/2011/10/002079. Comparison of effectiveness of ciprofloxacin and cefpodoxime in patients with acute attack of chronic middle ear infection [Comparison of efficacy and safety of ciprofloxacin and cefpodoxime in acute exacerbation of chronic suppurative otitis media: a randomized open labeled study]. Http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=3489 (first received 19 October 2011). [CENTRAL: CN‐01013255; CRS: 1743872]
    1. Ghosh A, Jana U, Khaowas A, Das S, Mandal A, Das N. Comparison of the effectiveness and safety of cefpodoxime and ciprofloxacin in acute exacerbation of chronic suppurative otitis media: a randomized, open‐labeled, phase IV clinical trial. Journal of Pharmacology & Pharmacotherapeutics 2012;3(4):320‐4. [CENTRAL: CN‐00905716; CRS: 1676041; EMBASE: 2013360430; PUBMED: 23326103] - PMC - PubMed
Granath 2007 {published data only}
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Gupta 2015 {published data only}
    1. Gupta C, Agrawal A, Gargav ND. Role of acetic acid irrigation in medical management of chronic suppurative otitis media: a comparative study. Indian Journal of Otolaryngology‐Head & Neck Surgery 2015;67(3):314‐8. [CENTRAL: CN‐01098823; CRS: 1829333; PUBMED: 26405670] - PMC - PubMed
Gyde 1981 {published data only}
    1. Gyde MC. A double‐blind comparative study of trimethoprim‐polymyxin B versus trimethoprim‐sulfacetamide‐polymyxin B otic solutions in the treatment of otorrhea. Journal of Laryngology and Otology 1981;95(3):251‐9. [CENTRAL: CN‐00024381; CRS: 959452; PUBMED: 6257815] - PubMed
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Harris 2016 {published data only}
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Helmi 2000 {published data only}
    1. Helmi A, Ratna D, Zainul A, Sosialisman E, Alfian FH, Bambang H. The efficacy and safety of ofloxacin otic solution for active suppurative otitis media. Faculty of Medicine, University of Indonesia, Jakarta, Indonesia Unpublished, 2000.
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Hemlin 1997 {published data only}
    1. Hemlin C, Carenfelt C, Papatziamos G. Single dose of betamethasone in combined medical treatment of secretory otitis media. Annals of Otology, Rhinology, and Laryngology 1997;106(5):359‐63. [CENTRAL: CN‐00139646; CRS: 1074207; PUBMED: 9153098] - PubMed
Hwang 2015 {published data only}
    1. Hwang JH, Lee JH, Hwang JH, Chung KM, Lee EJ, Yoon YJ, et al. Comparison of arbekacin and vancomycin in treatment of chronic suppurative otitis media by methicillin resistant Staphylococcus aureus. Journal of Korean Medical Science 2015;30(6):688‐93. [CENTRAL: CN‐01257881; CRS: 4910884; PUBMED: 26028918] - PMC - PubMed
    1. Lee JH, Hwang JH, Moon MK, Kim JS, Lee CS. Comparison of the usefulness of arbekacin and vancomycin in treating chronic suppurative otitis media due to methicillin resistant staphylococcus aureus. International Journal of Antimicrobial Agents 2015;45(52):S60‐1. [CRS: 7774347]
I‐HEAR‐BETA {published data only}
    1. Morris P, Leach AJ. Among Aboriginal children (2 months of age and up to 17 years of age) with chronic suppurative otitis media, is 4 months of povidone‐iodine ear wash and/or oral cotrimoxazole in addition to standard treatment (cleaning and dry mopping with tissue spears plus topical ciprofloxacin) superior to standard treatment alone for resolving ear discharge? A 2x2 factorial randomised controlled trial. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365450 (first received 5 March 2014). [ACTRN12614000234617]
Indudharan 2005 {published data only}
    1. Indudharan R, Ashraful Haq J, Mohamad H, Mohamad Z, Mohamad Z. Topical antibiotic versus antibiotic steroid combination in the management of chronic suppurative otitis media. XVI World Congress of Otorhinolaryngology Head and Neck Surgery; 1997 Mar 2‐7; Sydney. 1997:1153‐8. [CENTRAL: CN‐00549107; CRS: 1379203]
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ISRCTN12149720 {published data only}
    1. ISRCTN12149720. Treatment of chronic suppurative otitis media with the antimicrobial peptide OP‐145 (AMP60.4Ac) in adults. Http://www.isrctn.com/isrctn12149720 (first received 13 October 2015). [CENTRAL: CN‐01601160; CRS: 8519222]
ISRCTN84220089 {published data only}
    1. ISRCTN84220089. An interventional, randomized, double‐blind, placebo‐controlled, parallel‐assignment, safety/efficacy study for treatment of chronic middle ear infection in adult patients with the antimicrobial peptide OP‐145. Http://isrctn.org/ISRCTN84220089 (first received 18 January 2008). [CENTRAL: CN‐01013171; CRS: 1743788]
ISRCTN86106121 {published data only}
    1. ISRCTN86106121. Treatment of chronic suppurative otitis media (CSOM) in Kenyan children: a double blind, two‐group comparative randomised placebo controlled trial [Randomised trial of treatment of chronic suppurative otitis media (CSOM) in Kenyan children]. Http://isrctn.org/ISRCTN86106121 (first received 17 December 2008). [CENTRAL: CN‐00766897; CRS: 1564692]
Jahn 1984 {published data only}
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    1. Jang CH, Song CH, Wang PC, Wang PC. Topical vancomycin for chronic suppurative otitis media with methicillin‐resistant Staphylococcus aureus otorrhoea. Journal of Laryngology and Otology 2004;118(8):645‐7. [CENTRAL: CN‐00497367; CRS: 1342862] - PubMed
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Jiang 2016 {published data only}
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Kadar 2003 {published data only}
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Kashiwamura 2004 {published data only}
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Kenna 1986 {published data only}
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Khon 2012 {published data only}
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Lancaster 1999 {published data only}
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Lancaster 2003 {published data only}
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Lazo Saenz 1999 {published data only}
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Leach 2008 {published data only}
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Legent 1994 {published data only}
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Lorentzen 1978 {published data only}
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Macfadyen 2005 {published data only}
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Mendelman 1992 {published data only}
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Merifield 1993 {published data only}
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Mesure 1973 {published data only}
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Morgon 1976 {published data only}
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NCT02592096 {published data only}
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NCT02817347 {published data only}
    1. NCT02817347. A clinical trial of YH1177 in patients with otitis media and otorrhea [A randomized, double‐blind, multicenter, phase2 trial to evaluate the safety and efficacy of YH1177 or YH1177‐D otic solution in patients with otitis media and otorrhea]. Https://clinicaltrials.gov/show/nct02817347 (first received 29 June 2016). [CENTRAL: CN‐01383192; CRS: 6333841]
Nwokoye 2015 {published data only}
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Onali 2018 {published data only}
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Papastavros 1989 {published data only}
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Picozzi 1983 {published data only}
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Picozzi 1984 {published data only}
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Poliakova 1991 {published data only}
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Principi 1995 {published data only}
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Quick 1973 {published data only}
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Rotimi 1990 {published data only}
    1. Rotimi VO, Olabiyi DA, Banjo TO, Okeowo PA. Randomised comparative efficacy of clindamycin, metronidazole, and lincomycin, plus gentamicin in chronic suppurative otitis media. West African Journal of Medicine 1990;9(2):89‐97. [CENTRAL: CN‐00072366; CRS: 1007294; PUBMED: 2268574] - PubMed
Saez‐Llorens 2005 {published data only}
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Sanchez Gonzales 2001 {published data only}
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Shkil' 1964 {published data only}
    1. Shkil' AM. On the complex treatment of chronic suppurative otitis media [O kompleksnom lechenii khronicheskikh gnoinykh srednikh otitov]. Zhurnal Ushnykh, Nosovykh I Gorlovykh Boleznei [Journal of Otology, Rhinology, and Laryngologie [sic]] 1964;24(6):17‐22. [CRS: 6614470; PUBMED: 5876597] - PubMed
Singhal 1992 {published data only}
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Smith 1996 {published data only}
    1. Mackenzie IJ, Smith AW, Hatcher J, Machria I. Randomized controlled trial of treatment of chronic suppurative otitis media in Kenyan school children [abstract]. Clinical Otolaryngology 1997;22:81. [CENTRAL: CN‐00262473; CRS: 1161574]
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Somekh 2000 {published data only}
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Stenstrom 1991 {published data only}
    1. Stenstrom C, Lundgren K, Ingvarsson L, Bertilson SO. Amoxycillin/clavulanate versus amoxycillin in recurrent otitis media and therapeutic failure in children. Acta Oto‐laryngologica 1991;111(1):120‐9. [CENTRAL: CN‐00074552; CRS: 1009472; EMBASE: 1991091483; PUBMED: 1901686] - PubMed
Subramaniam 2001 {published data only}
    1. Subramaniam K, Jalaludin M, Krishnan G. Comparative study of ofloxacin otic drops versus neomycin‐polymixin b‐hydrocortisone in the medical management of chronic suppurative otitis media. Department of ORL, University Malaya Medical Center, Kuala Lumpur, Malaysia Unpublished, 2000.
    1. Subramaniam K, Jaludin M, Krishnan G. Comparative study of ofloxacin otic drops versus neomycin‐polymixin hydrocortisone in the medical management of chronic suppurative otitis media. 9th ASEAN ORL Head and Neck Congress, 31 March‐1 April, 2001. Singapore, 2001.
Sultan 2017 {published data only}
    1. Sultan SSN, Alsaady MA. Role of levofloxacin for treatment of chronic suppurative otitis media: sample of Iraqi patients. Asian Journal of Pharmaceutical and Clinical Research 2017;10(9):358‐60. [CRS: 7778490; EMBASE: 618371938]
Sumitsawan 1995 {published data only}
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Supiyaphun 1995 {published data only}
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Thomsen 1976 {published data only}
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Tong 1996 {published data only}
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van der Veen 2007 {published data only}
    1. Boonacker CW, Veen EL, Wilt GJ, Schilder AG, Rovers MM. Trimethoprim‐sulfamethoxazole in children with chronic otitis media: a randomized comparison of costs and effects. Otology & Neurotology 2008;29(7):961‐4. [CENTRAL: CN‐00666283; CRS: 1473130; PUBMED: 18758386] - PubMed
    1. Miller JL, Honey BL, Johnson PN, Hagemann TM. Effectiveness of trimethoprim/sulfamethoxazole for children with chronic active otitis media. Pediatrics 2007;120(6):1403. [8527167; PUBMED: 18055693] - PubMed
    1. NCT00189098. Effectiveness of sulfamethoxazole‐trimethoprim in the treatment of chronic otitis media. Https://clinicaltrials.gov/show/nct00189098 (first received 16 September 2005). [CENTRAL: CN‐01039521; CRS: 1770119]
    1. Verhoeff M, Rovers MM, Sanders EAM, Schilder AGM. The COCO‐study: a randomized clinical trial of the efficacy of trimethoprim‐sulfamethoxazole (co‐trimoxazole) in children with chronic suppurative otitis media. Clinical Otolaryngology and Allied Sciences 2004;29(4):460. [CENTRAL: CN‐00874123; CRS: 1647964]
    1. Veen EL, Rovers MM, Albers FW, Sanders EA, Schilder AG. Effectiveness of trimethoprim/sulfamethoxazole for children with chronic active otitis media: a randomized, placebo‐controlled trial. Pediatrics 2007;119(5):897‐904. [CENTRAL: CN‐00588516; CRS: 1415321; PUBMED: 17473089] - PubMed
van Dongen 2014 {published data only}
    1. NTR1481. Comparison of ototopical antibiotic‐steroid drops or oral antibiotics versus watchful waiting in children with acute tympanostomy tube otorrhea [Comparison of bacicoline‐B eardrops or oral Augmentin versus watchful waiting in children with acute tympanostomy tube otorrhea]. Http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1481 (first received 6 October 2008). [CENTRAL: CN‐00974948; CRS: 1705907]
    1. Dongen TMA, Heijden GJMG, Venekamp RP, Rovers MM, Schilder AGM. A trial of treatment for acute otorrhea in children with tympanostomy tubes. New England Journal of Medicine 2014;370(8):723‐33. [CENTRAL: CN‐00982484; CRS: 1713315; EMBASE: 2014119997; PUBMED: 24552319] - PubMed
van Hasselt 1998b {published data only}
    1. Hasselt P. Management of chronic suppurative otitis media in developing countries. 2nd European Congress on Tropical Medicine; 1998; Liverpool, UK. 1998:57. [CENTRAL: CN‐00519674; CRS: 1362363]
    1. Hasselt P, Kregten E. Treatment of chronic suppurative otitis media with ofloxacin in hydroxypropyl methylcellulose ear drops: a clinical/bacteriological study in a rural area of Malawi. International Journal of Pediatric Otorhinolaryngology 2002;63(1):49‐56. [CENTRAL: CN‐00519676; CRS: 1362365] - PubMed
Vishwakarma 2015 {published data only}
    1. Vishwakarma K, Khan FA, Nizamuddin S, Signh P, Yadav L. Role of topical acetic acid in comparison to gentamicin for the management of chronic suppurative otitis media. International Archives of Biomedical and Clinical Research 2015;1(1):13‐6. [CENTRAL: CN‐01601165; CRS: 8527169]
Wilde 1995 {published data only}
    1. Wilde AD, England J, Jones AS. An alternative to regular dressings for otitis externa and chronic supperative otitis media?. Journal of Laryngology and Otology 1995;109(2):101‐3. [CENTRAL: CN‐00112706; CRS: 1047325; EMBASE: 1995094313; PUBMED: 7535834] - PubMed
Wintermeyer 1997 {published data only}
    1. Wintermeyer SM, Hart MC, Nahata MC. Efficacy of ototopical ciprofloxacin in pediatric patients with otorrhea. Otolaryngology ‐ Head & Neck Surgery 1997;116(4):450‐3. [CRS: 7775009] - PubMed
Wright 2009 {published data only}
    1. Wright D, Safranek S. Treatment of otitis media with perforated tympanic membrane. American Family Physician 2009;79(8):650‐2. [CRS: 7775012] - PubMed
Xu 1999 {published data only}
    1. Xu Y, Yu J, Song Q. Clinical and experimental study on treatment of chronic pyogenic tympanitis with shenlian ear‐drops. Zhongguo Zhong Xi Yi Jie He za Zhi [Chinese Journal of Integrated Traditional and Western Medicine] 1999;19(8):477‐80. [CENTRAL: CN‐00376881; CRS: 1242470; PUBMED: 11783228] - PubMed
Yuen 1994 {published data only}
    1. Yuen PW, Lau SK, Chau PY, Hui Y, Wong SF, Wong S, et al. Ofloxacin eardrop treatment for active chronic suppurative otitis media: prospective randomized study. American Journal of Otology 1994;15(5):670‐3. [CENTRAL: CN‐00122894; CRS: 1057491; EMBASE: 1994288260; PUBMED: 8572070] - PubMed

References to studies awaiting assessment

Abdul 2005 {published data only}
    1. Abdul ME, Shabana Y, Ghonim M. Comparative study of the efficacy of local ciprofloxacin versus aluminum acetate 3.5% in the management of active chronic suppurative otitis media [CSOM]. New Egyptian Journal of Medicine 2005;32:190‐3.
Abes 1998 {published data only}
    1. Abes J, Jamir J, Gloria‐Cruz MT, Gumban V, Seredrica G. Comparative efficacy and safety of ofloxacin and polymixin otic drops for chronic suppurative otitis media. UPM Journal 1998;4:59–70.

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References to other published versions of this review

Brennan‐Jones 2018b
    1. Brennan‐Jones CG, Head K, Chong LY, Tu N, Burton MJ, Schilder AGM, et al. Topical antibiotics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. [DOI: 10.1002/14651858.CD013051] - DOI - PMC - PubMed

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