Effects of betamethasone dipropionate plus an antihistamine in patients with external otitis

In a prospective multicenter, randomized, double-masked trial, 30 patients with external otitis received betamethasone dipropionate in a 0.05% solutio n for 11 days. Fifty percent of the patients were assigned randomly to rece ive concomitant treatment with loratadine: to help control itching, and 50% received placebo. The status of the external auditory canal (EAC) was asse ssed on days 0, 3, 7, 11, and 21 according to a new scoring system that gra ded color, the extension of redness out;side the EAC, swelling, and effusio n, Eighteen patients underwent sampling for a bacteriologic culture at the start of treatment; 14 cultures showed positive findings. The EAC status im proved rapidly, and by day II it was almost normal in all patients, Pain an d sleep disturbances disappeared by day 7; at which point itching was eithe r nonexistent or mild. All patients were able to resume work after 3 days o f treatment. At the end of the study, 29 (97%) of the 30 patients were cure d. The addition of loratadine to the treatment did not improve results sign ificantly. External otitis is generally treated with a combination of a ste roid and an antibiotic. Results of this study suggest that external of it i s, whether culture-positive or not, can be cured using a group III steroid alone.