Eardrops Are Most Effective for Acute Tympanostomy Tube Otorrhea

Acute otorrhea from otitis media is a common complication of tympanostomy tubes. In a randomized open-label study, researchers in Europe compared the effectiveness of oral amoxicillin-clavulanate suspension (3 doses daily for 1 week), eardrops containing hydrocortisone-bacitracin-colistin (5 drops, 3 times daily for 1 week), or 2 weeks of observation in 230 children (age range,1–10 years) with symptoms of tympanostomy-tube otorrhea.

At 2 weeks, only 5% of children treated with eardrops had otorrhea, compared with 44% in the oral antibiotic group and 55% in the observation group (number needed to treat, 3 and 2, respectively). The median duration of the initial episode of otorrhea was significantly shorter with eardrops than with oral antibiotics (4 vs. 5 days) or in the observation group (12 days). During 6 months of follow-up, median number of days with otorrhea was 5 versus 13 and 15 days, respectively. Twenty-one percent of children receiving eardrops had pain or discomfort when drops were administered, and 23% of children receiving oral antibiotics had gastrointestinal symptoms. Quality-of-life score did not differ significantly among the groups.