Otoxic eardrops and tympanic membrane perforations: Time for a change?

    Research output: Contribution to journalReview article

    2 Citations (Scopus)

    Abstract

    Until recently the only available antibiotic eardrops for treatment of the discharging middle ear and mastoid cavity have been potentially ototoxic. With the advent of non-ototoxic fluoroquinolone eardrops, consensus panels in the USA, Canada and the UK have advocated the preferential use of these agents in the open middle ear. However, in Australia, no fluoroquinolone topical agent is approved for use with tympanic membrane perforations, and when used as an 'off label' eardrop, none is on the Pharmaceutical Benefits Scheme. This creates an ethical dilemma, particularly with best practice management of chronic suppurative otitis media in indigenous children. Despite concerns regarding resistance issues with ototopical use of systemic antibiotics, bacterial resistance has not been documented in major studies. For equity and ethical reasons, Australian regulatory authorities should consider approving a sterile non-ototoxic eardrop for use in the open middle ear.
    Original languageEnglish
    Pages (from-to)401-404
    JournalJournal of Paediatrics and Child Health
    Volume41
    DOIs
    Publication statusPublished - 2005

    Fingerprint

    Tympanic Membrane Perforation
    Middle Ear
    Fluoroquinolones
    Bacterial Drug Resistance
    Suppurative Otitis Media
    Mastoid
    Practice Management
    Practice Guidelines
    Canada
    Anti-Bacterial Agents
    Pharmaceutical Preparations
    Therapeutics

    Cite this

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    title = "Otoxic eardrops and tympanic membrane perforations: Time for a change?",
    abstract = "Until recently the only available antibiotic eardrops for treatment of the discharging middle ear and mastoid cavity have been potentially ototoxic. With the advent of non-ototoxic fluoroquinolone eardrops, consensus panels in the USA, Canada and the UK have advocated the preferential use of these agents in the open middle ear. However, in Australia, no fluoroquinolone topical agent is approved for use with tympanic membrane perforations, and when used as an 'off label' eardrop, none is on the Pharmaceutical Benefits Scheme. This creates an ethical dilemma, particularly with best practice management of chronic suppurative otitis media in indigenous children. Despite concerns regarding resistance issues with ototopical use of systemic antibiotics, bacterial resistance has not been documented in major studies. For equity and ethical reasons, Australian regulatory authorities should consider approving a sterile non-ototoxic eardrop for use in the open middle ear.",
    author = "Harvey Coates",
    year = "2005",
    doi = "10.1111/j.1440-1754.2005.00657.x",
    language = "English",
    volume = "41",
    pages = "401--404",
    journal = "Journal of Paediatric and Child Health",
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    publisher = "John Wiley & Sons",

    }

    Otoxic eardrops and tympanic membrane perforations: Time for a change? / Coates, Harvey.

    In: Journal of Paediatrics and Child Health, Vol. 41, 2005, p. 401-404.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - Otoxic eardrops and tympanic membrane perforations: Time for a change?

    AU - Coates, Harvey

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    AB - Until recently the only available antibiotic eardrops for treatment of the discharging middle ear and mastoid cavity have been potentially ototoxic. With the advent of non-ototoxic fluoroquinolone eardrops, consensus panels in the USA, Canada and the UK have advocated the preferential use of these agents in the open middle ear. However, in Australia, no fluoroquinolone topical agent is approved for use with tympanic membrane perforations, and when used as an 'off label' eardrop, none is on the Pharmaceutical Benefits Scheme. This creates an ethical dilemma, particularly with best practice management of chronic suppurative otitis media in indigenous children. Despite concerns regarding resistance issues with ototopical use of systemic antibiotics, bacterial resistance has not been documented in major studies. For equity and ethical reasons, Australian regulatory authorities should consider approving a sterile non-ototoxic eardrop for use in the open middle ear.

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