Antibiotics versus non-antibiotic treatments for acute otitis externa: A systematic review and meta-analysis.
Abstract
Background: Otitis externa is a condition causing inflammation of the outer ear canal, which presents with itching, discharge and pain. Most cases of acute otitis externa are caused by bacterial infection and are thus treated with antibiotics. This systematic review and meta-analysis of randomised controlled trials aims to assess the effectiveness of topical non-antibiotic treatments compared to topical antibiotic treatment for the treatment of acute otitis externa. Methods: Systematic review and meta-analysis databases searched: Cochrane Library including ClinicalTrials.gov; MEDLINE; World Health Organisation International Clinical Trials Registry Platform and Web of Science to identify randomised clinical trials evaluating topical antibiotics and topical non-antibiotic agents in adults and children with acute otitis externa. Non-antibiotic therapeutics for comparison with topical antibiotics included antiseptics, steroids, non-pharmaceuticals and astringents. Results: Seventeen trials were eligible for inclusion, with 10 combined in meta-analysis. Data could be pooled comparing antiseptic and steroid monotherapies with topical antibiotic agents. There were no significant differences in cure rates in any pairwise comparisons. Individually, the majority of studies favoured topical antiseptics or steroids over antibiotics, however these differences were not significant when pooled in meta-analysis. Conclusion: Antiseptic, steroid and antibiotic monotherapies are all effective for the management of acute otitis externa. There is insufficient evidence to suggest that topical antiseptic or steroid agents are superior or inferior to topical antibiotics. Keywords: acute otitis externa; meta analysis; systematic review; topical antibiotics; topical therapies.Citation
Di Traglia R, Tudor-Green B, Muzaffar J, Borsetto D, Smith ME. Antibiotics versus non-antibiotic treatments for acute otitis externa: A systematic review and meta-analysis. Clin Otolaryngol. 2023 Aug 7. doi: 10.1111/coa.14084. Epub ahead of print.Type
ArticleAdditional Links
https://onlinelibrary.wiley.com/doi/full/10.1111/coa.14084PMID
37550850Journal
Clinical OtolaryngologyPublisher
Wileyae974a485f413a2113503eed53cd6c53
10.1111/coa.14084