Ear Drops Beat Oral Medications in Children With Tympanostomy-Tube Otorrhea

A new study suggests antibiotic-glucocorticoid ear drops are superior to oral medications in children who suffer from acute otorrhea following the insertion of tympanostomy tubes for recurrent ear infections.

For their trial published Feb. 20, 2014, in The New England Journal of Medicine, Thijs van Dongen, MD, and colleagues in the Netherlands randomized children aged between 1-10 years with uncomplicated acute tympanostomy-tube otorrhea to the hydrocortisone—bacitracin–colistin ear drops, oral amoxicillin–clavulanate suspension, or an initial observational approach.

After 2 weeks, only 5% of the children who received the antibiotic-glucocorticoid ear drops still had otorrhea, compared to 44% of those who received oral antibiotics and 55% of those who underwent observation. In addition, the median duration of the initial episode of discharge from the ears was 4 days for children treated with the ear drops, versus 5 days for those who received oral antibiotics (P< 0.001) and 12 days for those assigned to initial observation (P< 0.001).

According to the authors, treatment-related adverse events were mild, and no complications of otitis media — including local cellulitis, perichondritis, mastoiditis, and intracranial complications &mdash; were reported at 2 weeks.