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Meta-Analysis
. 2025 Jun 9;6(6):CD013055.
doi: 10.1002/14651858.CD013055.pub3.

Topical antiseptics for chronic suppurative otitis media

Karen Head  1 , Lee Yee Chong  1 , Mahmood F Bhutta  2 , Jessica Daw  3 , Tamara Veselinović  3 , Peter S Morris  4 , Shyan Vijayasekaran  5   6   7   8 , Anne Gm Schilder  9 , Christopher G Brennan-Jones  3   8
Affiliations
Meta-Analysis

Topical antiseptics for chronic suppurative otitis media

Karen Head et al. Cochrane Database Syst Rev. .

Abstract

Background: Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial 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. Topical antiseptics, a possible treatment for CSOM, inhibit the micro-organisms that may be responsible for the infection. Antiseptics can be used alone or in addition to other treatments for CSOM, such as antibiotics or ear cleaning (aural toileting). However, the effects of topical antiseptics for CSOM remain unclear. This is an update of a review last published in 2020, with one new study added. It is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.

Objectives: To assess the effects of topical antiseptics for people with CSOM.

Search methods: We searched the Cochrane ENT Register, CENTRAL, Ovid MEDLINE, Ovid Embase, and five other databases. We also searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. The date of the latest search was 15 June 2022.

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 antiseptic agent 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 antiseptics (a) compared to placebo or no intervention, and (b) compared to another topical antiseptic (e.g. topical antiseptic A versus topical antiseptic B). Within each comparison, we separated studies into (a) those in which both groups of participants had received aural toileting in addition to the topical antiseptics, and those where neither group had received aural toileting, and (b) those in which both groups had received some other concomitant treatment (such as antibiotics) and those with no such concomitant treatment.

Data collection and analysis: We used standard Cochrane methodological procedures. 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 were hearing, serious complications, and ototoxicity. We used GRADE to assess the certainty of the evidence for each outcome.

Main results: We found one new study (32 participants) in this update, for a total of six included studies with 435 participants (over four studies), plus 222 ears that could not be accounted for in participant numbers (in two studies). Four studies compared topical antiseptics with no treatment or placebo, and two studies compared two different topical antiseptics (boric acid versus acetic acid, and boric acid versus hydrogen peroxide). The two core comparisons of interest are reported below; other comparisons are described in the Results section of the review. No study measured health-related quality of life or ear pain. 1. Topical antiseptic versus placebo or no treatment Three studies (297 participants plus 174 ears) compared topical antiseptics with no treatment. Evidence from one study (unclear number of participants, 174 ears) is very uncertain about the effect of a single application of povidone iodine in hydroxypropyl methyl-cellulose (HPMC) on resolution of ear discharge at one week compared to HPMC alone; however, these results were only provided by ear (rather than by participant) and therefore could not be used quantitatively (very low-certainty evidence). One study (254 children; cluster-RCT) found that boric acid in alcohol ear drops with dry mopping may help resolution of ear discharge after four weeks compared with dry mopping alone, but the evidence is very uncertain (risk ratio (RR) 1.73, 95% confidence interval (CI) 1.21 to 2.47; 180 participants; very low-certainty evidence). We made adjustments to the data to account for the intracluster correlation. This study narratively described no clear differences in suspected ototoxicity or hearing outcomes between study arms, but the evidence is very uncertain (very low-certainty evidence). Evidence from one study (43 children; 58 ears) is very uncertain about the effect of antiseptics on serious complications. The study reported one case of mastoiditis and one of meningitis with focal encephalitis; however, it was unclear whether these were detected pre-randomisation or during/after treatment. 2. Topical antiseptics versus no treatment/placebo, where both study arms received systemic antibiotics One study (32 participants) compared topical povidone iodine with placebo (saline) in conjunction with oral amoxicillin and dry mopping. Topical povidone iodine with oral amoxicillin and dry mopping may increase resolution of ear discharge at one to two weeks (RR 3.25, 95% CI 1.35 to 7.84; 32 participants; low-certainty evidence). The study narratively reported no ototoxicity in the topical antiseptic arm; however, this was unclear for the placebo group, so we do not know if povidone iodine increases suspected ototoxicity (low-certainty evidence). The study did not assess resolution of ear discharge after four weeks, hearing, or serious complications.

Authors' conclusions: We are very uncertain about the effect of topical antiseptics on improving resolution of ear discharge in people with CSOM given the low and very low certainty of the evidence, which was mostly due to risk of bias and imprecision. However, there is some evidence suggesting that boric acid in alcohol ear drops with dry mopping may help resolution of ear discharge compared with dry mopping alone, and that topical povidone iodine may be more effective than placebo (where both arms used systemic beta-lactam antibiotics and dry mopping). There is insufficient evidence to draw any conclusions about harmful effects. Limitations of the review include lack of recency in data, and limited information on certain population groups or interventions.

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Conflict of interest statement

Karen Head: none known.

Lee Yee Chong: none known.

Mahmood F Bhutta is employed as a specialist in otology (management of ear disease), both in the public and private sector. He has written academic articles on the topic, but without financial incentive. MB declares consulting fees (daily attendance rate) and travel expenses from the World Health Organization for his participation in the Programme for Prevention of Deafness and Hearing Loss (personal payment).

Jessica Daw: none known.

Tamara Veselinovic: none known.

Peter S Morris is a Consultant Paediatrician involved in clinical practice and research at the Royal Darwin Hospital and the Menzies School of Health Research, Darwin, Australia. He has conducted clinical trials of chronic suppurative otitis media and co‐ordinated otitis media guidelines in 2000, 2009, and 2019 while employed as a researcher at the Menzies School of Health Research, who has declared a position on the topic. PM is a former Editor of Cochrane Acute Respiratory Infections Group (2000 to 2021) but was not involved in the editorial process for this review. He is involved with the I‐HEAR‐BETA study, an ongoing clinical trial conducted by the Menzies School of Health Research, which may be eligible for inclusion in the work; the study was funded by the National Health and Medical Research Committee, Australia. PM 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 the National Health and Medical Research Council of Australia addressing treatments for chronic suppurative otitis media.

Shyan Vijayasekaran has previously provided independent consultancy services to Smith+Nephew as a key opinion leader, though not in relation to any treatments in this review (personal payment).

Anne GM Schilder is a Paediatric ENT surgeon at Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Trust. Until April 2020, she was the Co‐ordinating Editor at Cochrane ENT. She had no role in the editorial process for this review.

Christopher G Brennan‐Jones is a Clinical Audiologist at Perth Children's Hospital in Perth, Western Australia. He declares a Research Fellowship from the Western Australia Department of Health (personal payment). Professor 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, but this is not a paid position.

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References

References to studies included in this review

Al‐Abbasi 2006 {published data only}
    1. Al-Abbasi A. Efficacy of povidone iodine in treatment of active chronic suppurative otitis media. Journal of the Islamic Medical Association of North America 2006;38(3):118-21. [DOI: 10.5915/38-3-5986] - DOI
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
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
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
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
van Hasselt 1998b {published and unpublished data}
    1. Van Hasselt P. A controlled trial of the treatment of CSOM in rural Malawi. In: Conference of the Pan-African Federation of Otorhinolaryngological Societies (PAFOS) in Nairobi. Nairobi, Kenya, 1998.
    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. - PubMed

References to studies excluded from this review

Aminifarshidmehr 1996 {published data only}
    1. Aminifarshidmehr N. The management of chronic suppurative otitis media with acid media solution. American Journal of Otology 1996;17(1):24-5. [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
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 and 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
Macfadyen 2005a {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
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
van Hasselt 1997a {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]
Yogi 2020 {published data only}
    1. Yogi V, Vyas P, Trivedi B, Chhabra B. To compare the efficacy of topically acetic acid irrigation with topical antibiotics in medical management of tubotympanic chronic supprative otits media (CSOM). International Journal of Medical Science and Education 2020;7(1):41-50. [CENTRAL: CN-02299997]

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.
Hu 2011 {published data only}
    1. Hu X. Clinical analysis of chronic suppurative otitis media combined with fungal infection. Chinese Journal of Nosocomiology 2011;9:1790-1.

References to ongoing studies

I‐HEAR‐BETA {published data only}ACTRN12614000234617
    1. ACTRN12614000234617. 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/ (first received 25 March 2014). [ANZCTR ID: ACTRN12614000234617]
    1. Wigger C, Leach AJ, Beissbarth J, Oguoma V, Lennox R, Nelson S, et al. Povidone-iodine ear wash and oral cotrimoxazole for chronic suppurative otitis media in Australian aboriginal children: study protocol for factorial design randomised controlled trial. BMC Pharmacology & Toxicology 2019;20(1):46. [CENTRAL: CN-01954293] [PMID: ] - PMC - PubMed

Additional references

Adriztina 2018
    1. Adriztina I, Adenin LI, Lubis YM. Efficacy of boric acid as a treatment of choice for chronic suppurative otitis media and its ototoxicity. Korean Journal of Family Medicine 2018;39:2-9. - PMC - PubMed
Asmatullah 2015
    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] [PMID: ]
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 (Clinical Research Ed.) 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. [DOI: 10.13110/humanbiology.87.2.0092] [PMID: ] - DOI - PubMed
Bhutta 2020
    1. Bhutta MF, Head K, Chong LY, Daw J Schilder AG, Burton MJ, Brennan-Jones CG. Aural toilet (ear cleaning) for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2020, Issue 9. Art. No: CD013057. [DOI: 10.1002/14651858.CD013057.pub2] - DOI - PMC - PubMed
Bhutta 2024
    1. Bhutta MF, Leach AJ, Brennan-Jones CG. Chronic suppurative otitis media. Lancet 2024;403(10441):2339-48. [DOI: 10.1016/S0140-6736(24)00259-9] [PMID: ] - DOI - PubMed
Brennan‐Jones 2020a
    1. Brennan-Jones CG, Head K, Chong LY, Burton MJ, Schilder AG, Bhutta MF. Topical antibiotics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2020, Issue 1. Art. No: CD013051. [DOI: 10.1002/14651858.CD013051.pub2] - DOI - PMC - PubMed
Brennan‐Jones 2020b
    1. Brennan-Jones CG, Chong LY, Head K, Burton MJ, Schilder AG, Bhutta MF. Topical antibiotics with steroids for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2020, Issue 1. Art. No: CD013054. [DOI: 10.1002/14651858.CD013054.pub2] - DOI - PMC - PubMed
Chong 2021a
    1. Chong LY, Head K, Webster KE, Daw J, Richmond P, Snelling T, et al. Systemic antibiotics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No: CD013052. [DOI: 10.1002/14651858.CD013052.pub2] - DOI - PMC - PubMed
Chong 2021b
    1. Chong LY, Head K, Webster KE, Daw J, Richmond P, Snelling T, et al. Topical versus systemic antibiotics for chronic suppurative otitis media. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No: CD013053. [DOI: 10.1002/14651858.CD013053.pub2] - DOI - PMC - PubMed
de Miguel 1999
    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
Dubey 2007
    1. Dubey SP, Larawin V. Complications of chronic suppurative otitis media and their management. Laryngoscope 2007;117(2):264-7. [DOI: 10.1007/s12070-015-0836-5] [PMCID: PMC4678280] [PMID: ] - DOI - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical Research Ed.) 1997;315(7109):629-34. [DOI: 10.1136/bmj.315.7109.629] [PMCID: PMC2127453] [PMID: ] - DOI - 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. [DOI: 10.1093/ije/31.1.140] [PMID: ] - DOI - 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. [DOI: 10.1016/j.ijporl.2009.12.004] [PMID: ] - DOI - 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. [DOI: 10.1177/00034894021110s304] [PMID: ] - DOI - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Hamilton (ON): McMaster University (developed by Evidence Prime), 2025. Available at https://www.gradepro.org.
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 https://training.cochrane.org/handbook/archive/v5.1/.
Handbook 2023
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from https://training.cochrane.org/handbook/archive/v6.4.
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. [DOI: 10.1067/mhn.2000.107813] [PMID: ] - DOI - PubMed
Head 2020b
    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 2020, Issue 1. Art. No: CD013056. [DOI: 10.1002/14651858.CD013056.pub2] - DOI - PMC - PubMed
Ho 2025
    1. Ho CS, Wong CT, Aung TT, Lakshminarayanan R, Mehta JS, Rauz S, et al. Antimicrobial resistance: a concise update. Lancet Microbe 2025;6(1):100947. - PubMed
Jamalullah 2016
    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]
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
Kiris 1998
    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
Kirkham 2017
    1. Kirkham JJ, Davis K, Altman DG, Blazeby JM, Clarke M, Tunis S, et al. Core outcome set – standards for development: the COS-STAD recommendations. PLOS Medicine 2017;14(11):e1002447. [DOI: 10.1371/journal.pmed.1002447] - DOI - PMC - PubMed
Leach 2021
    1. Leach AJ, Morris PS, Coates HL, Nelson S, O'Leary SJ, Richmond PC, et al. Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: summary of recommendations. Medical Journal of Australia 2021;214(5):228-33. [DOI: 10.5694/mja2.50953] [PMCID: PMC7985866] [PMID: ] - DOI - PMC - PubMed
Macfadyen 2005b
    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
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
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. [DOI: 10.1371/journal.pone.0036226] [PMCID: PMC3340347] [PMID: ] - DOI - 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;0507:1. [CENTRAL: PMC3412293] [PMID: ] - PMC - PubMed
Nadol 2000
    1. Nadol JB Jr, 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
Nwokoye 2015
    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
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. [PMID: ] - PubMed
Onali 2018
    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
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
Page 2021
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLOS Medicine 2021;18(3):e1003583. [DOI: 10.1371/journal.pmed.1003583] - DOI - PMC - PubMed
Phillips 2007
    1. Phillips JS, Yung MW, Burton MJ, Swan IR. Evidence review and ENT-UK consensus report for the use ofaminoglycoside-containing ear drops in the presence of an open middle ear. Clinical Otolaryngology 2007;32(5):330-6. [DOI: 10.1111/j.1749-4486.2007.01532.x] [PMID: ] - DOI - 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
Povedano 1995
    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
    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
Renukananda 2014
    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
RevMan 2024 [Computer program]
    1. Review Manager (RevMan). Version 7.12.0. The Cochrane Collaboration, 2024. Available at https://revman.cochrane.org.
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
Siddique 2016
    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
    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 school children. Lancet 1996;348(9035):1128-33. [CENTRAL: CN-00132594] [EMBASE: 1996327505] [PMID: ] - 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] [PMID: ] - DOI - PubMed
Tamir 2023
    1. Tamir SO, Bialasiewicz S, Brennan-Jones CG, Der C, Kariv L, Macharia I, et al. ISOM 2023 research Panel 4 – Diagnostics and microbiology of otitis media. International Journal of Pediatric Otorhinolaryngology 2023;174:111741. [DOI: 10.1016/j.ijporl.2023.111741] [PMID: ] - 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. [PMID: ] - PubMed
Waterworth 2022
    1. Waterworth CJ, Marella M, O'Donovan J, Bright T, Dowell R, Bhutta MF. Barriers to access to ear and hearing care services in low- and middle- income countries: a scoping review. Global Public Health 2022;17(12):3869-93. [DOI: 10.1080/17441692.2022.2053734] [PMID: ] - DOI - PubMed
WebPlotDigitizer 2024 [Computer program]
    1. WebPlotDigitizer. Ankit Rohatgi. Automeris, 2024. https://automeris.io/WebPlotDigitizer/.
WHO 2004
    1. World Health Organization. Chronic Suppurative Otitis Media (CSOM): Burden of Illness and Management Options. Geneva: World Health Organization, 2004.
Yorgancılar 2013
    1. Yorgancilar 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 2018
    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] - DOI - PMC - PubMed
Head 2020a
    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 2020, Issue 1. Art. No: CD013055. [DOI: 10.1002/14651858.CD013055.pub2] - DOI - PMC - PubMed

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