Objective
To evaluate the effectiveness of prophylactic polymyxin B sulfate-neomycin sulfate-hydrocortisone drops in decreasing the incidence of posttympanostomy otorrhea.
Design
Prospective randomized controlled study.
Setting
University referral center.
Patients
Three hundred patients undergoing tympanostomy tube placement (including those undergoing tonsillectomy, adenoidectomy, or both) were randomized into three groups.
Intervention
The use of polymyxin B-neomycin-hydrocortisone drops. Patients in group 1 received no antibiotic drops; group 2, a single dose intraoperatively, and group 3, an intraoperative dose followed by a 5-day course.
Main Outcome Measure
Posttympanostomy otorrhea.
Results
A statistically significant decrease was observed in the incidence of posttympanostomy otorrhea between the control (16.4%) and treatment groups (group 2, 8.3%; group 3, 8.1%) (P=.011). A single dose of antibiotics was effective when patients' middle ears were dry or had serous effusions. A 5-day course was indicated for those whose ears had mucoid or purulent contents.
Conclusions
Antibiotic ear drops are indicated in all patients. A single dose is as effective as a 5-day course, but our data support a longer course in certain subgroups.
(Arch Otolaryngol Head Neck Surg. 1995;121:445-448)
