Efficacy of combination of acetic acid and ciprofloxacin eardrops versus only ciprofloxacin eardrops in achieving dry ears in chronic suppurative otitis media

Abstract

Background: As per WHO, the chronic inflammatory condition involving the middle ear and mastoid cavity, resulting in recurrent ear discharge, otherwise known as otorrhoea, through perforation of the eardrum or tympanic membrane, is known as chronic suppurative otitis media (CSOM). Recurrent middle ear infections are known to produce a myriad of intracranial and extracranial complications. CSOM is considered a biofilm disease, wherein biofilms are found to be the most prevalent microbial form, playing a crucial role in the chronicity of the infections and observed resistance to antibiotics. Thus disruption of the biofilm layer is necessary for the management of CSOM. This can be achieved by aural toileting and topical 2% acetic ear drops. Aim: To study the efficacy of the combination of acetic acid and ciprofloxacin eardrops versus only ciprofloxacin ear drops in achieving dry ears in chronic suppurative otitis media. Materials and methods: Sixty-three patients diagnosed with CSOM (mucosal type) were randomly divided into two groups: Group A — who received both 2% acetic acid and ciprofloxacin ear drops and Group B — who received only Ciprofloxacin ear drops; thrice daily. Additionally, both groups received systemic oral antibiotic being tab. ciprofloxacin 500 mg twice daily for 14 days. Weekly follow-up was done for 2 weeks and compared on the basis of otological symptom score. Results: Both combination of acetic acid with ciprofloxacin and only ciprofloxacin ear drops significantly reduced the amount of ear discharge (P < 0.001) by the second visit, but the reduction in the amount of otorrhoea in Group A was found to be more significant than in Group B (P = 0.014). Also, the former was significantly more effective in achieving and maintaining dry ears by the third visit (P < 0.001). Conclusion: Combination of acetic acid and ciprofloxacin ear drops was found to be more effective than only ciprofloxacin ear drops in achieving and maintaining dry ears while treating CSOM.