COMPARATIVE EFFICACY OF TOPICAL CIPROFLOXACIN EAR DROPS VS COMBINATION OF TOPICALAND ORAL CIPROFLOXACIN IN THE FIRST LINE MANAGEMENT OF DISCHARGING CHRONIC SUPPURATIVE OTITIS MEDIA IN POPULATION VISITING IN TERTIATRY CARE HOSPITAL WESTERN UTTAR PRADE

Introduction:- Chronic Suppurative Otitis Media (CSOM) is a persistent inflammatory disease of the middle ear mucoperiosteum, influenced by socio-economic factors like poor hygiene and malnutrition. It presents in non-cholesteatomatous (central perforation) and cholesteatomatous (marginal/attic perforation) forms, with the latter posing a higher risk of complications. CSOM management is challenging due to antibiotic misuse, leading to masked infections and resistant strains. Regular microbial evaluation is essential for effective treatment. This study aims to identify causative organisms through culture and sensitivity testing and assess the therapeutic response to ciprofloxacin. Aim:- Comparative efficacy of topical ciprofloxacin ear drops vs combination of topical and oral ciprofloxacin in the first line management of discharging chronic suppurative otitis media in population visiting in tertiatry care hospital western Uttar Pradesh. Materials And Methods:- This prospective randomized clinical trial includes 100 patients (≥18 years) with bacterial otorrhea and chronic tympanic membrane perforation persisting >21 days. They are randomly assigned to Group A (ciprofloxacin ear drops) or Group B (topical + oral ciprofloxacin) for 14 days. Compliance is assessed at two weeks, and non-compliant patients are replaced. Cure is defined as the absence of otorrhea or negative bacterial culture, with nonresponders reassessed at three weeks. Persistent cases in Group Areceive systemic antibiotics, while Group B continues or adjusts therapy based on culture. Clinical failures at three weeks are managed accordingly, and unresolved cases are monitored at eight weeks. Outcomes are analyzed statistically, and non-compliant patients are excluded. Results: This study on active-stage safe-type CSOM found Pseudomonas aeruginosa (34%) as the most common organism, followed by Staphylococcus aureus (23%) and Klebsiella (17%). Topical ciprofloxacin was as effective as the combination therapy, but recurrence was higher with ear drops alone. Thus, while effective, topical ciprofloxacin alone may increase the risk of recurrence in CSOM without cholesteatoma.