Steroid Antibiotic Pack Versus 10% Ichthammol Glycerol Pack in Management of Acute Otitis Externa: A Comparative Study
Article Sidebar
-
Acute otitis externa, 10% ichthammol glycerol pack, steroid antibiotic pack, tragal tenderness
Abstract
Acute otitis externa is a common clinical condition that presents with rapid onset of otalgia, fullness, otorrhea and canal oedema. Moisture in-ear canal appears to be an important predisposing factor. The most common etiological agents include Pseudomonas aeruginosa and Staphylococcus aureus. Management includes control of otalgia and elimination of infection from the ear. Precipitating factors should be avoided. The main objective of this study is to compare the efficacy of 10% ichthammol glycerol ear pack with steroid antibiotic ear pack in the treatment of acute otitis externa. Institutional Review Board (IRB) clearance was obtained, and a prospective randomised clinical trial was conducted in the ENT outpatient department of Saveetha Medical College & Hospital, Thandalam, from January 2020 to March 2020. Patients were explained about the study in detail, and consent was obtained. The patients were randomised, and 10% ichthammol glycerol pack and steroid antibiotic pack were used in alternate turns for aural packing. Pain rating was done using Numerical rating scale (NRS) before and 48 hours post-treatment and also in each subsequent hospital visit till complete subsidence of symptoms. Among the 85 patients included in the study, 42 (49.4%) were males, and 43 (50.6%) were females. Most of them belonged to the age group 31-40 years (41.2%). In the patients treated with steroid antibiotic pack, only 2.3% of the patients had severe pain, whereas 14% had moderate pain and 83.7% had only mild pain. Whereas among those treated with 10% ichthammol glycerol pack, 9.5% of the patients had severe pain, whereas 35.7% had moderate pain and 54.8% had mild pain. On analysis, the results were statistically significant, and there was considerable pain relief with steroid antibiotic pack. Therefore, our study showed that steroid antibiotic pack is more effective in relieving the symptoms, thereby reducing the number of hospital visits when compared to 10% ichthammol glycerol pack.
Full text article
References
Adhikari, P., Bhatta, R., Bhandari, S., (Bhatta), M. P. 2011. Comparison of steroid antibiotic pack and 10% ichthammol glycerine pack in relieving pain of acute otitis externa in children. International Journal of Pediatric Otorhinolaryngology, 75(4):500–503.
Bojrab, D. I., Bruderly, T., Abdulrazzak, Y. 1996. Otitis Externa. Otolaryngologic Clinics of North America, 29(5):761–782.
Gayko, G., Cholcha, W., Kietzmann, M. 2000. Anti-inflammatory, antibacterial and antimycotic effects of dark sulfonated shale oil (ichtham- mol). Berliner und Munchener tierarztliche Wochenschrift, 113(10):368–373.
Hornigold, R., Gillett, D., Kiverniti, E., Harries, M. 2008. The management of otitis externa: a randomised controlled trial of a glycerol and icthammol ribbon gauze versus topical antibiotic and steroid drops. European Archives of Oto-Rhino- Laryngology, 265(10):1199–1203.
Khalil, N., Chaudhry, S., Ahmad, Z., Amin, B., Malik, F., Rizvi, S. S. Z. 2019. Comparison of 10% ichthammol glycerine wick and topical steroid- antibiotic ear drops in the treatment of diffuse otitis externa. Rawal Medical Journal, 44(3):537–540.
Linstrom, J. C., Lucento, E. F. 1989. Infections of the external ear. Bailey BJ, Johnson’s JT Head and neck surgery-Otolaryngology. 4th ed. Philadelphia: Lippincott Williams and Wilkins.
Lum, C. L., Jeyanthi, S., Prepageran, N., Vadivelu, J., Raman, R. 2009. Antibacterial and antifungal properties of human cerumen.
Mahmood, A. 2004. Sensitivity and spectrum of bacterial isolates in infectious otitis externa. Journal of the College of Physicians and Surgeons–Pakistan: JCPSP, 14(9):580–580.
Masood, A., Moumoulidis, I., Ray, S., Chawla, O., Panesar, J. 2008. A randomised controlled trial comparing Triadcortyl® with 10% glycerine ichthammol in the initial treatment of severe acute otitis externa. European Archives of Oto-Rhino- Laryngology, 265(8):881–885.
Monga, J., Sharma, S., Singh, P., Pathania, V. 2017. Efficacy of Ichthammol Glycerin Pack and Steroid Antibiotic Pack as Initial Treatment of Acute Otitis Externa: A Comparative Study. JMed SciCliRes, 8(5):26512–26517.
Neher, A., Nagl, M., Scholtz, A. W. 2008. Otitis externa: aetiology, diagnostic and therapy. HNO, 56(10):1067–1080.
Nilssen, E., Wormald, P. J., Oliver, S. 1996. Glycerol and ichthammol: medicinal solution or mythical potion? The Journal of Laryngology & Otology, 110(4):319–321.
Patel, M., Dehadaray, A. 2018. Povidone-iodine and glycerine for treatment of acute otitis externa. Saudi Journal for Health Sciences, 7(3):178–178.
Rosenfeld, R. M., Schwartz, S. R., Cannon, C. R., Roland, P. S., Simon, G. R., Kumar, K. A., Huang, W. W., Haskell, H. W., Robertson, P. J. 2014. Clinical practice guideline: acute otitis externa. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery, 150(Supple 1): 1-24.
Sander, R. 2001. Otitis externa: a practical guide to treatment and prevention. American family physician, 63(5):927–942.
Schaefer, P., Baugh, R. F. 2012. Acute otitis externa: an update. American Family Physician, 86(11):1055–1061.
Shrestha, B. L., Shrestha, I., Amatya, R. C. M., Dhakal, A. 2010. Effective Treatment of Acute Otitis Externa: a Comparison of Steroid Antibiotic Versus 10% Ichthammol Glycerine Pack.
Shrestha, K., Shah, R., Sapkota, S. 2019. Efficacy of 10% Ichthammol Glycerine Pack and Steroid- antibiotic Pack for Relieving Pain in Acute Otitis Externa. A Comparative Study. Birat Journal of Health Sciences, 4(1):634–638.
Smith, I. M., Keay, D. G., Buxton, P. K. 1990. Con- tact hypersensitivity in patients with chronic otitis externa. Clinical Otolaryngology, 15(2):155–158.
Wipperman, J. 2014. Otitis Externa. Primary Care: Clinics in Office Practice, 41(1):1–9.
Authors
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.