Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Jan 6;1(1):CD013056.
doi: 10.1002/14651858.CD013056.pub2.

Antibiotics versus topical antiseptics for chronic suppurative otitis media

Karen Head  1 , Lee-Yee Chong  1 , Mahmood F Bhutta  2 , Peter S Morris  3 , Shyan Vijayasekaran  4   5 , Martin J Burton  6 , Anne Gm Schilder  7 , Christopher G Brennan-Jones  8
Affiliations
Meta-Analysis

Antibiotics versus topical antiseptics for chronic suppurative otitis media

Karen Head et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and infection 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. Antibiotics and antiseptics kill or inhibit the micro-organisms that may be responsible for the infection. Antibiotics can be applied topically or administered systemically via the oral or injection route. Antiseptics are always directly applied to the ear (topically).

Objectives: To assess the effectiveness of antibiotics versus antiseptics for people with chronic suppurative otitis media (CSOM).

Search methods: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL; 2019, Issue 4, 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Ovid MEDLINE; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials.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 patients (adults and children) who had chronic ear discharge of unknown cause or CSOM, where ear discharge had continued for more than two weeks. The intervention was any single, or combination of, antibiotic agent, whether applied topically (without steroids) or systemically. The comparison was any single, or combination of, topical antiseptic agent, applied as ear drops, powders or irrigations, or as part of an aural toileting procedure. Two comparisons were topical antiseptics compared to: a) topical antibiotics or b) systemic antibiotics. Within each comparison we separated where both groups of patients had received topical antibiotic a) alone or with aural toilet 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; and ear pain (otalgia) or discomfort or local irritation. Secondary outcomes included hearing, serious complications and ototoxicity measured in several ways.

Main results: We identified seven studies (935 participants) across four comparisons with antibiotics compared against acetic acid, aluminium acetate, boric acid and povidone-iodine. None of the included studies reported the outcomes of quality of life or serious complications. A. Topical antiseptic (acetic acid) versus topical antibiotics (quinolones or aminoglycosides) It is very uncertain if there is a difference in resolution of ear discharge with acetic acid compared with aminoglycosides at one to two weeks (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.72 to 1.08; 1 study; 100 participants; very low-certainty evidence). No study reported results for ear discharge after four weeks. It was very uncertain if there was more ear pain, discomfort or local irritation with acetic acid or topical antibiotics due to the low numbers of participants reporting events (RR 0.16, 95% CI 0.02 to 1.34; 2 RCTs; 189 participants; very low-certainty evidence). No differences between groups were reported narratively for hearing (quinolones) or suspected ototoxicity (aminoglycosides) (very low-certainty evidence). B. Topical antiseptic (aluminium acetate) versus topical antibiotics No results for the one study comparing topical antibiotics with aluminium acetate could be used in the review. C. Topical antiseptic (boric acid) versus topical antibiotics (quinolones) One study reported more participants with resolution of ear discharge when using topical antibiotics (quinolones) compared with boric acid ear drops at between one to two weeks (risk ratio (RR) 1.56, 95% confidence interval (CI) 1.27 to 1.92; 1 study; 409 participants; moderate-certainty evidence). This means that one additional person will have resolution of ear discharge for every five people receiving topical antibiotics (compared with boric acid) at two weeks. No study reported results for ear discharge after four weeks. There was a bigger improvement in hearing in the topical antibiotic group compared to the topical antiseptic group (mean difference (MD) 2.79 decibels (dB), 95% CI 0.48 to 5.10; 1 study; 390 participants; low-certainty evidence) but this difference may not be clinically significant. There may be more ear pain, discomfort or irritation with boric acid compared with quinolones (RR 0.56, 95% CI 0.32 to 0.98; 2 studies; 510 participants; low-certainty evidence). Suspected ototoxicity was not reported. D. Topical antiseptic (povidone-iodine) versus topical antibiotics (quinolones) It is uncertain if there is a difference between quinolones and povidone-iodine with respect to resolution of ear discharge at one to two weeks (RR 1.02, 95% CI 0.82 to 1.26; 1 RCT, 39 participants; very low-certainty evidence). The study reported qualitatively that there were no differences between the groups for hearing and no patients developed ototoxic effects (very low-certainty evidence). No results for resolution of ear discharge beyond four weeks, or ear pain, discomfort or irritation, were reported. E. Topical antiseptic (acetic acid) + aural toileting versus topical + systemic antibiotics (quinolones) One study reported that participants receiving topical and oral antibiotics had less resolution of ear discharge compared with acetic acid ear drops and aural toileting (suction clearance every two days) at one month (RR 0.69, 95% CI 0.53 to 0.90; 100 participants). The study did not report results for resolution of ear discharge at between one to two weeks, ear pain, discomfort or irritation, hearing or suspected ototoxicity.

Authors' conclusions: Treatment of CSOM with topical antibiotics (quinolones) probably results in an increase in resolution of ear discharge compared with boric acid at up to two weeks. There was limited evidence for the efficacy of other topical antibiotics or topical antiseptics and so we are unable to draw conclusions. Adverse events were not well reported.

PubMed Disclaimer

Conflict of interest statement

Karen Head: none known. Lee Yee Chong: none known. Mahmood F Bhutta: 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). Peter S Morris: Peter Morris has contributed to an Expert Advisory Group on chronic suppurative otitis media and conjugate pneumococcal vaccines in Australia for GlaxoSmithKline. He has also been a Chief Investigator on project grants from National Health and Medical Research Council of Australia addressing treatments for chronic suppurative otitis media. Shyan Vijayasekaran: 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. Christopher G Brennan‐Jones: none known.

Figures

1
1
Process for sifting search results and selecting studies for inclusion.
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 antibiotics versus acetic acid, Outcome 1: Resolution of ear discharge (1 to 2 weeks)
1.2
1.2. Analysis
Comparison 1: Topical antibiotics versus acetic acid, Outcome 2: Resolution of ear discharge (2 to 4 weeks)
1.3
1.3. Analysis
Comparison 1: Topical antibiotics versus acetic acid, Outcome 3: Ear pain, discomfort, irritation
2.1
2.1. Analysis
Comparison 2: Topical antibiotics versus aluminium acetate, Outcome 1: Ototoxicity
3.1
3.1. Analysis
Comparison 3: Topical antibiotics versus boric acid, Outcome 1: Resolution of ear discharge (1 to 2 weeks)
3.2
3.2. Analysis
Comparison 3: Topical antibiotics versus boric acid, Outcome 2: Resolution of ear discharge (2 to 4 weeks)
3.3
3.3. Analysis
Comparison 3: Topical antibiotics versus boric acid, Outcome 3: Ear pain, discomfort, irritation
3.4
3.4. Analysis
Comparison 3: Topical antibiotics versus boric acid, Outcome 4: Change in hearing
4.1
4.1. Analysis
Comparison 4: Topical antibiotics versus povidone‐iodine, Outcome 1: Resolution of ear discharge (1 to 2 weeks)
4.2
4.2. Analysis
Comparison 4: Topical antibiotics versus povidone‐iodine, Outcome 2: Resolution of ear discharge (2 to 4 weeks)
5.1
5.1. Analysis
Comparison 5: Topical and systemic antibiotics versus acetic acid, Outcome 1: Resolution of ear discharge (2 to 4 weeks)
5.2
5.2. Analysis
Comparison 5: Topical and systemic antibiotics versus acetic acid, Outcome 2: Resolution of ear discharge (after 4 weeks)
See this image and copyright information in PMC

References

References to studies included in this review

Fradis 1997 {published data only}
    1. Fradis M, Brodsky A, Ben-David J, Srugo I, Larboni J, Podoshin L. Chronic otitis media treated topically with ciprofloxacin or tobramycin. Archives of Otolaryngology--Head & Neck Surgery 1997;123(10):1057-60. [CENTRAL: CN-00144425] [PMID: ] - PubMed
    1. Podoshin L, Brodzki A, Fradis M, Ben-David J, Larboni J, Srugo I. Local treatment of purulent chronic otitis media with ciprofloxacin. Harefuah 1998;134(1):32-6, 78. [CENTRAL: CN-00682735] [PMID: ] - PubMed
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] [PMID: ] - PMC - PubMed
Jaya 2003 {published data only}
    1. Jaya C, Job A, Mathai E, Antonisamy B. Evaluation of topical povidone-iodine in chronic suppurative otitis media. Archives of Otolaryngology--Head & Neck Surgery 2003;129(10):1098-100. [CENTRAL: CN-00452670] [EMBASE: 37248310] [PMID: ] - PubMed
Loock 2012 {published data only}
    1. Loock J. Strategies in the medical treatment of active mucosal chronic otitis media suitable for all levels of healthcare: a randomized controlled trial. Clinical Otolaryngology 2012;37(Suppl 1):165-6. [CENTRAL: CN-01008068] [EMBASE: 71023646]
    1. Loock JW. 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. Clinical Otolaryngology 2012;37(4):261-70. [CENTRAL: CN-00850193] [EMBASE: 365535141] [PMID: ] - PubMed
Macfadyen 2005 {published data only}
    1. Macfadyen C, Gamble C, Garner P, Macharia I, Mackenzie I, Mugwe P, et al. Topical quinolone vs. antiseptic for treating chronic suppurative otitis media: a randomized controlled trial. Clinical Otolaryngology 2005;30(2):193-4. [CENTRAL: CN-00521519] [EMBASE: 2005185914] [PMID: ] - PubMed
    1. Macfadyen C, Gamble C, Garner P, Macharia I, Mackenzie I, Mugwe P, et al. Topical quinolone vs. antiseptic for treating chronic suppurative otitis media: a randomized controlled trial. Tropical Medicine & International Health 2005;10(2):190-7. [CENTRAL: CN-00502876] [EMBASE: 2005088099] [PMID: ] - PubMed
van Hasselt 1997 {published data only}
    1. Hasselt P, Van Hasselt P. Pilot trial of treatment of chronic suppurative otitis media (CSOM) with several types of ear drops in Nkota Kota District, Malawi. Internal Report of the Christian Blind Mission International 1997. [CENTRAL: CN-00519675]
    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] - 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]

References to studies excluded from this review

Asmatullah 2014 {published data only}
    1. Asmatullah, Khan Q, Nawaz G, Ullah G, Iqbal J, Khan M, et al. Comparison of efficacy of topical ofloxacin and gentamycin in tubotympanic type of chronic suppurative otitis media. Medical Forum Monthly 2015;25(12):68-71. [CENTRAL: CN-01084518] [EMBASE: 2015070065]
Boesorire 2000 {published data only}
    1. Boesoirie T. A comparative study between ofloxacin ear drop and neomycin-polymixin b-hydrocortisone ear drops on the chronic suppurative otitis media. In: 9th ASEAN ORL Head and Neck Congress 31 March-1 April, 2001. Singapore, 2001.
    1. Boesoirie T. A comparative study between ofloxacin ear drops and neomycin-polymixin b-hydrocortisone ear drops on the chronic suppurative otitis media. Department of ENT Head and Neck Surgery, University of Padjajaran, Bandung, Indonesia Unpublished, 2000.
Browning 1983 {published data only}
    1. Browning GG, Picozzi GL, Calder IT, Sweeney G. Controlled trial of medical treatment of active chronic otitis media. British Medical Journal (Clinical Research Ed.) 1983;287(6398):1024. [CENTRAL: CN-00032195] [PMID: ] - PMC - PubMed
    1. Picozzi CL, Calder I, Browning GG, Sweeney G. Controlled trial of medical treatment of active chronic otitis media. Clinical Otolaryngology and Allied Sciences 1982;7:137-8. [CENTRAL: CN-00262047] - PubMed
Browning 1988 {published data only}
    1. Browning GG, Gatehouse S, Calder IT. Medical management of active chronic otitis media: a controlled study. Journal of Laryngology and Otology 1988;102(6):491-5. [CENTRAL: CN-00054939] [PMID: ] - PubMed
Clayton 1990 {published data only}
    1. Clayton MI, Osborne JE, Rutherford D, Rivron RP. A double-blind, randomized, prospective trial of a topical antiseptic versus a topical antibiotic in the treatment of otorrhoea. Clinical Otolaryngology and Allied Sciences 1990;15(1):7-10. [CENTRAL: CN-00066816] [PMID: ] - PubMed
Couzos 2003 {published data only}
    1. Couzos S, Lea T, Mueller R, Coates H. A community-based, multi-centre, double-blind randomized controlled trial comparing the effectiveness of topical ciprofloxacin and Sofradex as treatment for chronic suppurative otitis media (CSOM) in aboriginal children. In: 8th International Symposium on Recent Advances in Otitis Media; 2003 Jun 3-7; Ft. Lauderdale (FL). 2003. [CENTRAL: CN-00449257]
    1. Couzos S, Lea T, Mueller R, Murray R, Culbong M. Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community-based, multicentre, double-blind randomised controlled trial. Medical Journal of Australia 2003;179(4):185-90. [CENTRAL: CN-00439955] [EMBASE: 37038200] [PMID: ] - PubMed
    1. Couzos S, Lea T, Murray R, Culbong M. 'We are not just participants-we are in charge': the NACCHO ear trial and the process for Aboriginal community-controlled health research. Ethnicity & Health 2005;10(2):91-111. [CENTRAL: CN-00512515] [EMBASE: 2005-04153-001] [PMID: ] - PubMed
    1. Couzos S. The Naccho Ear Trial - a community-based RCT to improve chronic suppurative otitis media affecting Aboriginal children. In: 2005 International Meeting of Australian Society of Paediatric Oto-rhino-laryngology; 2005 Jul 11-13; Denarau Island (Fiji). 2005. [CENTRAL: CN-00614782]
    1. Dugdale AE. Management of chronic suppurative otitis media. Medical Journal of Australia 2004;180(2):91. - PubMed
Crowther 1991 {published data only}
    1. Crowther JA, Simpson D. Medical treatment of chronic otitis media: steroid or antibiotic with steroid ear-drops? Clinical Otolaryngology and Allied Sciences 1991;16(2):142-4. [CENTRAL: CN-00076715] [PMID: ] - PubMed
de Miguel 1999 {published data only}
    1. De Miguel Martinez I, Vasallo Morillas JR, Ramos Macias A. Antimicrobial therapy in chronic suppurative otitis media [Terapeutica antimicrobiana en otitis media cronica supurada]. Acta Otorrinolaringologica Espanola 1999;50(1):15-9. [CENTRAL: CN-00161091] [PMID: ] - PubMed
Eason 1986 {published data only}
    1. Eason RJ, Harding E, Nicholson R, Nicholson D, Pada J, Gathercole J. Chronic suppurative otitis media in the Solomon Islands: a prospective, microbiological, audiometric and therapeutic survey. New Zealand Medical Journal 1986;99:812-5. [CENTRAL: CN-00045614] [PMID: ] - PubMed
Esposito 1990 {published data only}
    1. Esposito S, D'Errico G, Montanaro C. Topical and oral treatment of chronic otitis media with ciprofloxacin. A preliminary study. Archives of Otolaryngology--Head & Neck Surgery 1990;116(5):557-9. [CENTRAL: CN-00067110] [PMID: ] - PubMed
Esposito 1992 {published data only}
    1. Esposito S, Noviello S, D'Errico G, Montanaro C. Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media. Archives of Otolaryngology--Head & Neck Surgery 1992;118(8):842-4. [CENTRAL: CN-00086057] [PMID: ] - PubMed
Fliss 1990 {published data only}
    1. Fliss DM, Dagan R, Houri Z, Leiberman A. Medical management of chronic suppurative otitis media without cholesteatoma in children. Journal of Pediatrics 1990;116(6):991-6. [CENTRAL: CN-00067997] [PMID: ] - PubMed
    1. Leiberman A, Fliss DM, Dagan R. Medical treatment of chronic suppurative otitis media without cholesteatoma in children--a two-year follow-up. International Journal of Pediatric Otorhinolaryngology 1992;24(1):25-33. [PMID: ] - PubMed
Gendeh 2001 {published data only}
    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. In: 9th ASEAN ORL Head and Neck Congress, 31 March-1 April, 2001. Singapore, 2001.
    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. Http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=3489 (first received 19 October 2011). [CENTRAL: CN-01013255]
    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] [EMBASE: 2013360430] [PMID: ] - PMC - PubMed
Gyde 1978 {published data only}
    1. Gyde MC, Randall RF. Double-blind comparative study of trimethroprim-sulphacetamide-polymyxin b and gentamicin in the treatment of otorrhoea [Etude comparative a double insu de la trimethorprime-sulfacetamide=polymyxine B et de la gentamicine dans le traitement de l'otorrhee]. Annales d'Oto-laryngologie et de Chirurgie Cervico Faciale 1978;95(1-2):43-55. [CENTRAL: CN-00018235] [PMID: ] - PubMed
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.
    1. Helmi A, et al. The efficacy and safety of ofloxacin otic solution for active suppurative otitis media. In: 9th ASEAN ORL Head and Neck Congress, 31 Mar-1 Apr, 2001. Singapore, 2001.
Indudharan 2005 {published data only}
    1. Indudharan R, Valuyeetham KA, Raju SS. Role of glucocorticoids in ototopical antibiotic-steroid preparations in the treatment of chronic suppurative otitis media. Archives of Medical Research 2005;36(2):154-8. [CENTRAL: CN-00512134] [EMBASE: 2005181801] [PMID: ] - PubMed
Jamallulah 2016 {published data only}
    1. Jamalullah M, Babat M, Choudhury IM. Comparison of efficacy of topical gentamycin 0.3% with topical ciprofloxacin 0.6% in patients with active tubotympanic type of chronic suppurative otitis media. Isra Medical Journal 2016;8(1):14-8. [CENTRAL: CN-01601161]
Kasemsuwan 1997 {published data only}
    1. Kasemsuwan L, Clongsuesuek P. A double blind, prospective trial of topical ciprofloxacin versus normal saline solution in the treatment of otorrhoea. Clinical Otolaryngology and Allied Sciences 1997;22(1):44-6. [CENTRAL: CN-00138220] [PMID: ] - PubMed
Kaygusuz 2002 {published data only}
    1. Kaygusuz I, Karlidag T, Gok U, Yalcin S, Keles E, Demirbag E, et al. Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media [Kronik supuratif otitis media tedavisinde topikal siprofloksasin ve tobramisinin deksametazon ile kullanimi]. Kulak Burun Bogaz Ihtisas Dergisi: KBB [Journal of Ear, Nose, and Throat] 2002;9(2):106-11. [CENTRAL: CN-00397704] [PMID: ] - PubMed
Kiris 1998 {published data only}
    1. Kiris M, Berktas M, Egeli E, Kutluhan A. The efficacy of topical ciprofloxacin in the treatment of chronic suppurative otitis media. Ear, Nose & Throat Journal 1998;77(11):904-5, 909. [CENTRAL: CN-00306946] [PMID: ] - PubMed
Lazo Saenz 1999 {published data only}
    1. Lazo Saenz GJ, Alonzo Rojo SE, Perez Blanco A. Topical treatment in chronic otitis media [Tratamiento atopico en otitis media cronica]. Annales de Otorinolaringologia Mexicana 1999;45(1):17-9. [CENTRAL: CN-00477445]
Leach 2008 {published data only}
    1. Leach A, Wood Y, Gadil E, Stubbs E, Morris P. Topical ciprofloxin versus topical framycetin-gramicidin-dexamethasone in Australian aboriginal children with recently treated chronic suppurative otitis media: a randomized controlled trial. Pediatric Infectious Disease Journal 2008;27(8):692-8. [CENTRAL: CN-00650088] [EMBASE: 2009258884] [PMID: ] - PubMed
    1. Morris P, Leach A, Gadil E, Wood Y. Topical ciprofloxacin versus topical Sofradex in children with persistent chronic suppurative otitis media: a randomized controlled trial. In: 8th International Symposium on Recent Advances in Otitis Media; 2003 Jun 3-7; Fort Lauderdale (FL). 2003:289. [CENTRAL: CN-00449347]
Legent 1994 {published data only}
    1. Legent F, Bordure P, Beauvillain C, Berche P, Bordure PH. Controlled prospective study of oral ciprofloxacin versus amoxycillin/clavulanic acid in chronic suppurative otitis media in adults. Chemotherapy 1994;40(Suppl 1):16-23. [CENTRAL: CN-00108583] [EMBASE: 1994301734] [PMID: ] - PubMed
Liu 2003 {published data only}
    1. Liu J. The curative effect of Rifampicin solution in the treatment of chronic suppurative otitis media. Journal of Preclinical Medicine College of Shangdong University 2003;17(1):8-9. [CENTRAL: CN-00475923]
Lorente 1995 {published data only}
    1. Lorente J, Sabater F, Maristany M, Jimenez R, Menem J, Vinas J, et al. Multicenter study comparing the efficacy and tolerance of topical ciprofloxacin (0.3%) versus topical gentamicin (0.3%) in the treatment of simple, non-cholesteatomaous chronic otitis media in the suppurative phase [Estudio multicentrico comparativo de la eficacia y tolerancia de ciprofloxacino topico (0.3%) versus gentamicina topica (0.3%) en el tratamiento de la otitis media cronica simple no colesteatomatosa en fase supurativa]. Anales Otorrinolaringologicos Ibero-americanos 1995;22(5):521-33. [CENTRAL: CN-00120014] [PMID: ] - PubMed
    1. Sabater F, Maristany M, Mensa J, Villar E, Traserra J. Prospective double-blind randomized study of the efficacy and tolerance of topical ciprofloxacin vs topical gentamicin in the treatment of simple chronic otitis media and diffuse external otitis [Estudio prospectivo doble-ciego randomizado de la eficacia y tolerancia de ciprofloxacino topico versus gentamicina topica en el tratamiento de la otitis media cronica supurada simple y de la otitis externa difusa]. Acta Otorrinolaringologica Espanola 1996;47(3):217-20. [CENTRAL: CN-00129550] [PMID: ] - PubMed
Minja 2006 {published data only}
    1. Minja BM, Moshi NH, Ingvarsson L, Bastos I, Grenner J. Chronic suppurative otitis media in Tanzanian school children and its effects on hearing. East African Medical Journal 2006;83(6):322-5. [CENTRAL: CN-00568108] [PMID: ] - PubMed
Mira 1993 {published data only}
    1. Mira E, Benazzo M, Mira E, Benazzo M. Ceftizoxime as local therapy in the treatment of recurrences of chronic suppurative otitis media. Journal of Drug Development Supplement 1993;6(Suppl 2):39-44. [CENTRAL: CN-00362597]
    1. Mira E, Benazzo M, Mira E, Benazzo M. Clinical evaluation of ceftizoxime (EposerinR) as local therapy in the treatment of recurrences of chronic suppurative otitis media [Uso topico delle cefalosporine nel trattamento delle otiti medie purulente: valutazione della ceftizoxima (eposerin R)]. Rivista Italiana di Otorinolaringologia Audiologia e Foniatria 1992;12(4):219-25. [CENTRAL: CN-00624623]
Miro 2000 {published data only}
    1. Miro N. Controlled multicenter study on chronic suppurative otitis media treated with topical applications of ciprofloxacin 0.2% solution in single-dose containers or combination of polymyxin B, neomycin, and hydrocortisone suspension. Otolaryngology -Head & Neck Surgery 2000;123(5):617-23. [CENTRAL: CN-00331261] [PMID: ] - PubMed
Nawasreh 2001 {published data only}
    1. Nawasreh O, Fraihat A. Topical ciprofloxacin versus topical gentamicin for chronic otitis media. La Revue de Sante de la Mediterranee Orientale/Al-Majallah Al-sihhiyah Li-sharq Al-mutawassit [Eastern Mediterranean Health Journal] 2001;7(1-2):26-30. [CENTRAL: CN-00413339] [PMID: ] - PubMed
Nwokoye 2015 {published data only}
    1. Bakshi SS. Occurrence of otitis media in children and assessment of treatment options. Journal of Laryngology and Otology 2015;129(12):1253. [PMID: ] - PubMed
    1. Nwokoye NN, Egwari LO, Olubi OO. Occurrence of otitis media in children and assessment of treatment options. Journal of Laryngology and Otology 2015;129(8):779-83. [PMID: ] - PubMed
Onali 2018 {published data only}
    1. Onali MA, Bareeqa SB, Zia S, Ahmed SI, Owais A, Ahmad AN. Efficacy of empirical therapy with combined ciprofloxacin versus topical drops alone in patients with tubotympanic chronic suppurative otitis media: a randomized double-blind controlled trial. Clinical Medicine Insights. Ear Nose & Throat 2018;11:1179550617751907. [CENTRAL: CN-01445979] [PMID: ] - PMC - PubMed
Panchasara 2015 {published data only}
    1. CTRI/2012/07/002784. Efficacy and safety of ofloxacin and its combination with dexamethasone in chronic suppurative otitis media - a randomized, double blind, parallel group, comparative study. Http://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=4129 (first received 11 July 2012). [CENTRAL: CN-00867279] - PMC - PubMed
    1. Panchasara A, Singh A, Mandavia D, Jha S, Tripathi C. Efficacy and safety of ofloxacin and its combination with dexamethasone in chronic suppurative otitis media. A randomised, double blind, parallel group, comparative study. Acta Otorhinolaryngologica Italica 2015;35(1):39-44. [CENTRAL: CN-01098783] [EMBASE: 615600505] [PMID: ] - PMC - PubMed
Papastavros 1989 {published data only}
    1. Papastavros T, Giamarellou H, Varlejides S. Preoperative therapeutic considerations in chronic suppurative otitis media. Laryngoscope 1989;99(6 Pt 1):655-9. [CENTRAL: CN-00060222] [PMID: ] - PubMed
Picozzi 1983 {published data only}
    1. Picozzi G, Browning G, Calder I. Controlled trial of gentamicin and hydrocortisone ear drops with and without systemic metronidazole in the treatment of active chronic otitis media. Clinical Otolaryngology 1983;8:367-8. [CENTRAL: CN-00262065]
    1. Picozzi GL, Browning GG, Calder IT. Controlled trial of gentamicin and hydrocortisone ear drops with and without systemic metronidazole in the treatment of active chronic otitis media. Clinical Otolaryngology and Allied Sciences 1984;9:305. [CENTRAL: CN-00262101]
Povedano 1995 {published data only}
    1. Povedano Rodriguez V, Seco Pinero MJ, Jurado Ramos A, Lopez Villarejo P. Efficacy of topical ciprofloxacin in the treatment of chronic otorrhea [Eficacia del ciprofloxacino topico en el tratamiento de la otorrea cronica]. Acta Otorrinolaringologica Espanola 1995;46(1):15-8. [CENTRAL: CN-00113534] [PMID: ] - PubMed
Ramos 2003 {published data only}
    1. Ramos A, Ayudarte F, Miguel I, Cuyas JM, Cenjor C. Use of topical ciprofloxacin in chronic suppurating otitis media [Utilizacion del ciprofloxacino topico en la otitis media cronica supurada]. Acta Otorrinolaringologica Espanola 2003;54(7):485-90. [CENTRAL: CN-00614808] [PMID: ] - PubMed
Renuknanada 2014 {published data only}
    1. Renukananda GS, Santosh UP, George NM. Topical vs combination ciprofloxacin in the management of discharging chronic suppurative otitis media. Journal of Clinical and Diagnostic Research 2014;8(6):KC01-4. [CENTRAL: CN-00995335] [EMBASE: 2014430779] [PMID: ] - PMC - PubMed
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] [PMID: ] - PubMed
Roydhouse 1981 {published data only}
    1. Roydhouse N. Bromhexine for otitis media with effusion. New Zealand Medical Journal 1981;94(696):373-5. [CENTRAL: CN-00026842] [PMID: ] - PubMed
Sanchez Gonzales 2001 {published data only}
    1. Sanchez Gonzalez A, Gonzalez Galindo T. An open, comparative study of treatment of chronic middle ear otitis with levofloxacine vs amoxicillin/clavulanate [Spanish] [Estudio abierto comparativo del tratamiento de otitis media cronica con levofloxacino vs amoxicilina/clavulanato]. Investigacion Medica Internacional 2001;28(1):33-6. [CENTRAL: CN-00425055] [EMBASE: 2001355708]
Siddique 2016 {published data only}
    1. Siddique W, Hakeem A, Ashfaq K, Khan M, Gul AA. Comparison between the efficacy of topical ciprofloxacin with neomycin in the management of chronic suppurative otitis media. Pakistan Armed Forces Medical Journal 2016;66(2):235-9. [CENTRAL: CN-01601188]
Smith 1996 {published data only}
    1. Mackenzie IJ, Smith AW, Hatcher J, Macharia I. Randomized controlled trial of treatment of chronic suppurative otitis media in Kenyan school children [abstract]. Clinical Otolaryngology 1997;22:81. [CENTRAL: CN-00262473]
    1. Smith AW, Hatcher J, Mackenzie IJ, Thompson S, Bal I, Macharia I, et al. Randomised controlled trial of treatment of chronic suppurative otitis media in Kenyan schoolchildren. Lancet 1996;348(9035):1128-33. [CENTRAL: CN-00132594] [EMBASE: 1996327505] [PMID: ] - PubMed
Somekh 2000 {published data only}
    1. Somekh E, Cordova Z. Ceftazidime versus aztreonam in the treatment of pseudomonal chronic suppurative otitis media in children. Scandinavian Journal of Infectious Diseases 2000;32(2):197-9. [CENTRAL: CN-00296955] [PMID: ] - 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. In: 9th ASEAN ORL Head and Neck Congress, 31 March-1 April, 2001. Singapore, 2001.
Thorpe 2000 {published data only}
    1. Thorp MA, Gardiner IB, Prescott CA. Burow's solution in the treatment of active mucosal chronic suppurative otitis media: determining an effective dilution. Journal of Laryngology and Otology 2000;114(6):432-6. [CENTRAL: CN-00299231] [PMID: ] - PubMed
Tong 1996 {published data only}
    1. Tong MC, Woo JK, Hasselt CA. A double-blind comparative study of ofloxacin otic drops versus neomycin-polymyxin B-hydrocortisone otic drops in the medical treatment of chronic suppurative otitis media. Journal of Laryngology & Otology 1996;1104:309-14. - PubMed
Tutkun 1995 {published data only}
    1. Ozagar A, Koc A, Ciprut A, Tutkun A, Akdas F, Sehitoglu MA. Effects of topical otic preparations on hearing in chronic otitis media. Otolaryngology - Head and Neck Surgery 1997;117(4):405-8. [CENTRAL: CN-00144419] [PMID: ] - PubMed
    1. Tutkun A, Ozagar A, Koc A, Batman C, Uneri C, Sehitoglu MA. Treatment of chronic ear disease. Topical ciprofloxacin vs topical gentamicin. Archives of Otolaryngology--Head & Neck Surgery 1995;121(12):1414-6. [CENTRAL: CN-00121174] [PMID: ] - PubMed
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] [PMID: ] - 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. [PMID: ] - 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]
    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]
    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] [PMID: ] - PubMed
van Hasselt 1998a {published data only}
    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] - PubMed
    1. Hasselt P. A controlled trial of the treatment of CSOM in rural Malawi. In: Conference of the Pan-African Federation of Otorhinolaryngological Societies (PAFOS); 1998; Nairobi. Nairobi, 1998. [CENTRAL: CN-00519673]
van Hasselt 1998b {published data only}
    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] - PubMed
    1. Hasselt P. Management of chronic suppurative otitis media in developing countries. In: 2nd European Congress on Tropical Medicine; 1998; Liverpool (UK). 1998:57. [CENTRAL: CN-00519674]
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] [EMBASE: 1994288260] [PMID: ] - 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.

References to ongoing studies

I‐HEAR‐BETA {published data only}
    1. ACTRN12614000234617. Comparing cotrimoxazole and/or povidone-iodine ear wash with standard dry mopping and ciprofloxacin ear drops in Indigenous children with chronic suppurative otitis media (CSOM) [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]. Http://www.anzctr.org.au/ACTRN12614000234617.aspx (first received 5 March 2014). [CENTRAL: CN-01013236]

Additional references

Baumann 2011
    1. Baumann I, Gerendas B, Plinkert PK, Praetorius M. General and disease-specific quality of life in patients with chronic suppurative otitis media--a prospective study. Health and Quality of Life Outcomes 2011;9:48. [DOI: 10.1186/1477-7525-9-48] - DOI - PMC - PubMed
Bhutta 2011
    1. Bhutta MF, Williamson IG, Sudhoff HH. Cholesteatoma. BMJ 2011;342:d1088. [DOI: 10.1136/bmj.d1088] - DOI - PubMed
Bhutta 2016
    1. Bhutta MF. Evolution and otitis media: a review, and a model to explain high prevalence in indigenous populations. Human Biology 2016;87(2):92-108. - PubMed
Bhutta 2018
    1. Bhutta MF, Head K, Chong LY, Tu N, Schilder AGM, Burton MJ, et al. Aural toilet (ear cleaning) for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No: CD013057. [DOI: 10.1002/14651858.CD013057] - DOI - PMC - PubMed
Brennan‐Jones 2018a
    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. Art. No: CD013051. [DOI: 10.1002/14651858.CD013051.pub2] - DOI - PMC - PubMed
Brennan‐Jones 2018b
    1. Brennan-Jones CG, Chong LY, Head K, Tu N, Burton MJ, Schilder AGM, et al. Topical antibiotics with steroids for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No: CD013054. [DOI: 10.1002/14651858.CD013054] - DOI - PubMed
Chong 2018a
    1. Chong LY, Head K, Richmond P, Snelling T, Schilder AGM, Burton MJ, et al. Systemic antibiotics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No: CD013052. [DOI: 10.1002/14651858.CD013052] - DOI - PMC - PubMed
Chong 2018b
    1. Chong LY, Head K, Richmond P, Snelling T, Schilder AGM, Burton MJ, et al. Topical versus systemic antibiotics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No: CD013053. [DOI: 10.1002/14651858.CD013053] - DOI - PMC - PubMed
CONSORT 2010
    1. Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c332. - PMC - PubMed
Dubey 2007
    1. Dubey SP, Larawin V. Complications of chronic suppurative otitis media and their management. Laryngoscope 2007;117(2):264-7. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629-34. - PMC - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140-9. - PubMed
Elemraid 2010
    1. Elemraid MA, Brabin BJ, Fraser WD, Harper G, Faragher B, Atef Z, et al. Characteristics of hearing impairment in Yemeni children with chronic suppurative otitis media: a case-control study. International Journal of Pediatric Otorhinolaryngology 2010;74(3):283-6. - PubMed
Gates 2002
    1. Gates GA, Klein JO, Lim DJ, Mogi G, Ogra PL, Pararella MM, et al. Recent advances in otitis media. 1. Definitions, terminology, and classification of otitis media. Annals of Otology, Rhinology & Laryngology. Supplement 2002;188:8-18. - PubMed
Handbook 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Hannley 2000
    1. Hannley MT, Denneny JC, Holzer SS. Use of ototopical antibiotics in treating 3 common ear diseases. Otolaryngology - Head and Neck Surgery 2000;122(6):934-40. - PubMed
Head 2018a
    1. Head K, Chong LY, Bhutta MF, Morris PS, Vijayasekaran S, Burton MJ, et al. Topical antiseptics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No: CD013055. [DOI: 10.1002/14651858.CD013055.pub2] - DOI - PMC - PubMed
Jensen 2013
    1. Jensen RG, Koch A, Homøe P. The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media. International Journal of Pediatric Otorhinolaryngology 2013;77(9):1530-5. [DOI: 10.1016/j.ijporl.2013.06.025] - DOI - PubMed
Kirkham 2017
    1. Kirkham JJ, Davis K, Altman DG, Blazeby JM, Clarke M, Tunis S, Williamson PR. Core Outcome Set - STAndards for Development: The COS-STAD recommendations. PLoS Medicine 2017;14(11):e1002447. - PMC - PubMed
Mahadevan 2012
    1. Mahadevan M, Navarro-Locsin G, Tan HK, Yamanaka N, Sonsuwan N, Wang PC, et al. A review of the burden of disease due to otitis media in the Asia-Pacific. International Journal of Pediatric Otorhinolaryngology 2012;76(5):623-35. [DOI: 10.1016/j.ijporl.2012.02.031] - DOI - PubMed
McDonnell 1999
    1. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clinical Microbiology Reviews 1999;12:147–79. - PMC - PubMed
Mittal 2015
    1. Mittal R, Lisi CV, Gerring R, Mittal J, Mathee K, Narasimhan G, et al. Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. Journal of Medical Microbiology 2015;64(10):1103-16. [DOI: 10.1099/jmm.0.000155] - DOI - PMC - PubMed
Monasta 2012
    1. Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, et al. Burden of disease caused by otitis media: systematic review and global estimates. PloS One 2012;7(4):e36226. - PMC - PubMed
Morris 2010
    1. Morris P, Leach A, Shah P, Nelson S, Anand A, Allnutt R, et al. Recommendations for Clinical Care Guidelines on the Management of Otitis Media: In Aboriginal and Torres Strait Islander Populations. Canberra: Office for Aboriginal and Torres Strait Islander Health, Australian Government, 2010.
Morris 2012
    1. Morris P. Chronic suppurative otitis media. BMJ Clinical Evidence 2012;2012:0507. [CENTRAL: PMC3412293] [PMID: ] - PMC - PubMed
Nadol 2000
    1. Nadol JB, Staecker H, Gliklich RE. Outcomes assessment for chronic otitis media: the Chronic Ear Survey. Laryngoscope 2000;110(3 Pt 3):32-5. [DOI: 10.1097/00005537-200003002-00009] - DOI - PubMed
Olatoke 2008
    1. Olatoke F, Ologe FE, Nwawolo CC, Saka MJ. The prevalence of hearing loss among schoolchildren with chronic suppurative otitis media in Nigeria, and its effect on academic performance. Ear, Nose, & Throat Journal 2008;87(12):E19. - PubMed
Orji 2013
    1. Orji F. A survey of the burden of management of chronic suppurative otitis media in a developing country. Annals of Medical and Health Sciences Research 2013;4(3):598-601. [DOI: 10.4103/2141-9248.122126] - DOI - PMC - PubMed
Phillips 2007
    1. Phillips JS, Yung MW, Burton MJ, Swan IR. Evidence review and ENT-UK consensus report for the use of aminoglycoside-containing ear drops in the presence of an open middle ear. Clinical Otolaryngology 2007;32(5):330-6. - PubMed
Phillips 2014a
    1. Phillips JS, Yung MW. COMQ-12 scores in adult patients without chronic middle ear disease. Clinical Otolaryngology 2014;39(6):362-7. [DOI: 10.1111/coa.12306] - DOI - PubMed
Phillips 2014b
    1. Phillips JS, Haggard M, Yung M. A new health-related quality of life measure for active chronic otitis media (COMQ-12): development and initial validation. Otology & Neurotology 2014;35(3):454-8. [DOI: 10.1097/mao.0000000000000205] - DOI - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Schilder 2016
    1. Schilder AG, Chonmaitree T, Cripps AW, Rosenfeld RM, Casselbrant ML, Haggard MP, et al. Otitis media. Nature Reviews Disease Primers 2016;2:16063. [DOI: 10.1038/nrdp.2016.63] - DOI - PMC - PubMed
Sheldon 2005
    1. Sheldon AT. Antiseptic "resistance": real or perceived threat? Clinical Infectious Diseases 2005;40(11):1650-6. - PubMed
Stedman 2011
    1. Stedman MR, Curtin F, Elbourne DR, Kesselheim AS, Brookhart MA. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2011;40(6):1732-4. [DOI: 10.1093/ije/dyp345] - DOI - PubMed
van der Veen 2006
    1. Veen EL, Schilder AG, Heerbeek N, Verhoeff M, Zielhuis GA, Rovers MM. Predictors of chronic suppurative otitis media in children. Archives of Otolaryngology-Head & Neck Surgery 2006;132(10):1115-8. [DOI: 10.1001/archotol.132.10.1115] - DOI - PubMed
van Dinther 2015
    1. Dinther J, Droessaert V, Camp S, Vanspauwen R, Maryn Y, Zarowski A, et al. Validity and test-retest reliability of the Dutch Version of the Chronic Otitis Media Questionnaire 12 (COMQ-12). Journal of International Advanced Otology 2015;11(3):248-52. [DOI: 10.5152/iao.2015.1701] - DOI - PubMed
Verhoeff 2006
    1. Verhoeff M, Veen EL, Rovers MM, Sanders EA, Schilder AG. Chronic suppurative otitis media: a review. International Journal of Pediatric Otorhinolaryngology 2006;70(1):1-12. - PubMed
WHO 2004
    1. World Health Organization. Chronic Suppurative Otitis Media (CSOM): Burden of Illness and Management Options. Geneva, Switzerland: World Health Organization, 2004.
Yorgancılar 2013
    1. Yorgancılar E, Yildirim M, Gun R, Bakir S, Tekin R, Gocmez C, et al. Complications of chronic suppurative otitis media: a retrospective review. European Archives of Oto-rhino-laryngology 2013;270(1):69-76. [DOI: 10.1007/s00405-012-1924-8] - DOI - PubMed

References to other published versions of this review

Head 2018b
    1. Head K, Chong LY, Bhutta MF, Morris PS, Vijayasekaran S, Burton MJ, et al. Antibiotics versus topical antiseptics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2018, Issue 6. Art. No: CD013056. [DOI: 10.1002/14651858.CD013056] - DOI - PMC - PubMed
Macfadyen 2005a
    1. Macfadyen CA, Acuin JM, Gamble CL. Topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No: CD004618. [DOI: 10.1002/14651858.CD004618.pub2] - DOI - PMC - PubMed
Macfadyen 2006
    1. Macfadyen CA, Acuin JM, Gamble CL. Systemic antibiotics versus topical treatments for chronically discharging ears with underlying eardrum perforations. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No: CD005608. [DOI: 10.1002/14651858.CD005608] - DOI - PubMed

Publication types

MeSH terms