在免疫功能正常的患者中,在外用类固醇抗生素的基础上加用口服抗生素是否有效?

Ahmed Muhei Rasheed, Shamil Abbood Hilal, Azzam Muhsin Abbas
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引用次数: 1

摘要

背景:急性外耳炎(Acute otitis externa, AOE)是耳鼻喉科临床常见病,以细菌性疾病为主。AOE可引起严重的耳痛,并可中断日常活动;然而,约20%的患者需要卧床休息。目的:评价口服抗生素与外用类固醇抗生素联合治疗免疫功能正常患者耳道无并发症AOE的有效性。患者和方法:2020年4月至2021年10月期间,在伊拉克巴格达Al-Jerrahat教学医院和私人诊所耳鼻喉科进行了一项前瞻性比较临床研究。本研究共纳入68例免疫功能正常的患者(女性39例,男性29例),诊断为局限于耳道的无并发症AOE病例。患者分为两组。A组患者局部给予妥布霉素0.3%-地塞米松0.1%滴剂治疗,B组患者与A组患者治疗相同,同时口服环丙沙星片500 mg,每日2次。对患者进行日常随访,直至疼痛和水肿完全消退。疼痛的严重程度通过视觉模拟量表(VAS)评分来评估,而水肿则通过想象的水平线和垂直线将耳道划分为四分之一来分级。比较两组治疗后疼痛VAS评分和水肿评分。采用t检验进行统计学分析,计算p值,以确定a组与B组患者在疼痛和水肿缓解方面是否存在显著差异。结果:在整个随访期间,a组与B组患者在疼痛和水肿缓解方面无显著差异(p值均大于0.05)。结论:口服抗生素与外用类固醇抗生素联合治疗免疫功能正常的耳道单纯AOE无明显疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is adding an oral antibiotic with the topical antibiotic steroid useful in treatment of uncomplicated acute otitis externa in immunocompetent patients?

Background: Acute otitis externa (AOE) is a common disease encountered in otolaryngology practice, it is mainly bacterial in origin. AOE can cause severe otalgia and can interrupt the daily activities; however, bed rest is required in about 20% of the patients.

Aim: To evaluate the usefulness of adding an oral antibiotic with the topical antibiotic steroid in the treatment of uncomplicated AOE which is limited to the ear canal in immunocompetent patients.

Patients and methods: A prospective comparative clinical study was conducted in the department of otolaryngology at Al-Jerrahat Teaching Hospital and Private Clinic, Baghdad, Iraq, during the period from April 2020 to October 2021. A total of 68 immunocompetent patients (39 females and 29 males), diagnosed as cases of uncomplicated AOE which is limited to the ear canal, were included in this study. The patients were categorized into two groups. Patients in group A were treated with topical tobramycin 0.3%-dexamethasone 0.1% drops, while patients in group B received the same treatment as group A patients plus oral Ciprofloxacin tablets 500 mg twice daily. The patients were followed up on day-to-day basis until complete resolution of pain and edema. The severity of pain was assessed by visual analogue scale (VAS) scores, while edema was graded by dividing the ear canal by imaginary horizontal and vertical lines into four quarters. The post-treatment pain VAS scores and edema grades of both groups were compared. Statistical analysis using t-test was done to calculate P-value in order to find if there is a significant difference regarding the resolution of pain and edema between group A and group B.

Results: During the whole follow-up period there was no significant difference between group A and group B patients regarding the resolution of pain and edema (P-value was more than 0.05).

Conclusions: There is no significant benefit of adding an oral antibiotic with the topical antibiotic steroid in the treatment of uncomplicated AOE limited to the ear canal in immunocompetent patients.

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