Comparison of efficacy of neomycin/betamethasone otic solution alone with oral Amoxycillin plus neomycin/betamethasone otic solution in the treatment of chronic suppurative otitis media – Comparison of efficacy of tubotympanic, (SAFE) type during acu

ABSTRACT: Objective:- Comparison of efficacy of neomycin / betamethasone otic solution alone with oral amoxicillin plus neomycin / betamethasone otic solution in the treatment of chronic Suppurative otitis media- tubotympanic (safe) type during acute exacerbation. Materials and methods: - Patients were recruited from the out-patient clinic of the Department of Otorhinolaryngology Head & Neck Surgery from December 2023 to June 2024. Patients with age >12 years and with a diagnosis of CSOM-TT with acute exacerbation wear enrolled in the study and divided into two treatment groups. Group 1 received neomycin / betamethasone otic solution alone for ten days while Group 2 received oral amoxicillin for seven days plus the above otic solution for ten days. The primary outcome measure was attainment of dry ear (responder) evaluated after two weeks of the start of treatment. Non responding ears were subjected to culture of the discharge for bacteriological flora and drug resistant pattern. Justification: - Ear discharge is a major factor for CSOM especially amongst the children and poor hygiene people in Nepal. Ear discharge is one of the public health problem in Nepal. For starting preventive measures information on nature and extent of CSOM is required. This studies is intended to find necessary answer about the pattern of CSOM at Bheri Hospital which will guide the local bodies, district and national authorities to take necessary step for CSOM prevention to decrease disease for undeveloped country as Nepal. Results: - At two weeks of scheduled follow up, the percentage of ears which was dry in treatment Group 1was 70.6% and in treatment Group 2 it was 78.9% but the p value was not significant. Non responding ears predominantly grew Staphylococcus aureus and Pseudomonas species. Conclusion: - The combination of antibiotic / steroid otic solution with systemic antibiotic is not superior to antibiotic / steroid otic solution alone in the treatment of CSOM-TT during active stage. Keywords: Otic solution, neomycin/betamethasone, chronic suppurative