A comparison of cortisporin and ciprofloxacin otic drops as prophylaxis against post-tympanostomy otorrhea

Myringotomy and tube insertion, a common pediatric surgical procedure, is f requently complicated by purulent otorrhea. Many otolaryngologists routinel y use topical antibiotics as prophylaxis against post-tympanostomy otorrhea . The aminoglycosides (neomycin sulfate, tobramycin and gentamicin) contain ed in commonly used topical antibiotics as well as components of the soluti ons have been shown to be ototoxic in animal studies. Although little repor ted evidence of ototoxicity in humans exists, sporadic reports of sensorine ural hearing loss linked to topical antibiotic use do exist, and the potent ial for sensorineural hearing loss must be considered. The purpose of this study is to compare the rate of post-tympanostomy otorrhea in a double-blin ded randomized trial using either topical Ciprofloxacin, with no reported o totoxicity, or Cortisporin as prophylaxis. One hundred patients (200 ears) between ages 7 months and 11 years with a diagnosis of recurrent otitis med ia or chronic otitis media undergoing tympanostomy tube insertion were rand omized into two equal groups. Three drops of either drop A or B were placed into each ear at the time of tube insertion and then three times daily for 3 days. Patients were examined at 3 weeks and details of otorrhea were obt ained. The rate of otorrhea was analyzed using chi-square. The overall rate of otorrhea was 39 ears (19.5%), 17 (17%) ears for the Cortisporin group a nd 22 (22%) for the Ciprofloxacin group. The difference in rate of otorrhea was not statistically significant (P=0.372, 95% confidence interval equals -6-16%). Our data suggest that topical Cortisporin offers no benefit over Ciprofloxacin for post-operative otorrhea prophylaxis. Therefore we recomme nd topical quinolone prophylaxis, which should eliminate concerns about oto toxicity, without sacrificing efficacy. (C) 2001 Elsevier Science Ireland L td. All rights reserved.