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Evidence-based management of otitis media: a 5S model approach

Published online by Cambridge University Press:  28 January 2015

J D Wasson  and
M W Yung
J D Wasson*
Affiliation:
Department of Otolaryngology, Ipswich Hospital NHS Trust, Suffolk, UK
M W Yung
Affiliation:
Department of Otolaryngology, Ipswich Hospital NHS Trust, Suffolk, UK
*
Address for correspondence: Mr J D Wasson, Department of Otolaryngology, Ipswich Hospital NHS Trust, Ipswich, Suffolk IP4 5PD, UK E-mail: josephwasson@hotmail.com
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Abstract

Objective:

The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children.

Method:

Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review.

Results:

System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma.

Conclusion:

Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

Keywords

Otitis MediaOtitis Media with EffusionCholesteatomaReview
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 2 , February 2015 , pp. 112 - 119
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Haynes, RB. Of studies, syntheses, synopses, summaries, and systems: the ‘5S’ evolution of information services for evidence-based healthcare decisions. Evid Based Med 2006;11:162–4Google Scholar
2Haynes, RB. Of studies, summaries, synopses, and systems: the ‘4S'evolution of services for finding current best evidence. Evid Based Med 2001;6:36–8Google Scholar
3Greenhalgh, T. How to Read a Paper: the Basics of Evidence Based Medicine, 4th edn. Oxford: BMJ Books, 2010Google Scholar
4Acute Otitis Media in Children and Adolescents. International View, issue 2, 2012. Map of Medicine. In: http://mapofmedicine.com [17 August 2013]Google Scholar
5Otitis Media – Acute, version 1.0, 2009. PRODIGY. In: http://prodigy.clarity.co.uk [17 August 2013]Google Scholar
6Diagnosis and Management of Childhood Otitis Media in Primary Care. A National Clinical Guideline, 2003. Scottish Intercollegiate Guidelines Network. In: http://www.sign.ac.uk/pdf/sign66.pdf [17 August 2013]Google Scholar
7Respiratory tract infections – antibiotic prescribing. Prescribing antibiotics for self-limiting respiratory tract infections in adults and children in primary care. NICE Clinical guideline 69. National Institute for Health and Clinical Excellence. In: http://www.nice.org.uk/guidance/cg69/resources/guidance-respiratory-tract-infections-antibiotic-prescribing-pdf [17 August 2013]Google Scholar
8Gunasekera, H, Morris, PS, McIntyre, P, Craig, JC. Management of children with otitis media: a summary of evidence from recent systematic reviews. J Paediatr Child Health 2009;45:554–62Google Scholar
9British Infection Association. Management of infection guidance for primary care for consultation and local adaptation, 2011. Health Protection Agency. In: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1279888711402 [17 August 2013]Google Scholar
10American Academy of Pediatrics. Diagnosis and management of acute otitis media. Pediatrics 2004;113:1451–65Google Scholar
11Ministry of Health British Colombia. Otitis Media: Acute Otitis Media (AOM) and Otitis Media with Effusion (OME): Care guideline. British Columbia: Ministry of Health, British Columbia, 2010Google Scholar
12Cincinnati Children's Hospital Medical Center. Evidence based clinical practice guideline for medical management of acute otitis media in children 2 months to 13 years of age. Cincinnati, Ohio: Cincinnati Children's Hospital Medical Center, 2005Google Scholar
13Otitis media. In: British National Formulary. London: BMJ Group and RPS Publishing, 2011Google Scholar
14Hoberman, A, Paradise, JL, Rockette, HE, Shaikh, N, Wald, ER, Kearney, DH et al. Treatment of acute otitis media in children under 2 years of age. N Engl J Med 2011;364:105–15Google Scholar
15Damoiseaux, RAJM, Rovers, MM. AOM in children. Clin Evid 2011;5:301Google Scholar
16Leach, AJ, Morris, PS. Antibiotics for the prevention of acute and chronic suppurative otitis media in children. Cochrane Database Syst Rev 2006;(4):CD004401.Google Scholar
17Jansen, AG, Hak, E, Veenhoven, RH, Damoiseaux, RA, Schilder, AG, Sanders, EA. Pneumococcal conjugate vaccines for preventing otitis media. Cochrane Database Syst Rev 2009;(2):CD001480Google Scholar
18McDonald, S, Langton, H, Nunez, DA. Grommets (ventilation tubes) for recurrent acute otitis media in children. Cochrane Database Syst Rev 2008;(4):CD004741Google Scholar
19Le, CT, Freeman, DW, Fireman, BH. Evaluation of ventilating tubes and myringotomy in the treatment of recurrent or persistent otitis media. Pediatr Infect Dis J 1991;10:2–11Google Scholar
20Jefferson, T, Rivetti, A, Harnden, A, Di Pietrantonj, C, Demicheli, V. Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev 2008;(2):CD004879Google Scholar
21Uhari, M, Kontiokari, T, Koskela, M, Niemelä, M. Xylitol chewing gum in prevention of acute otitis media: double blind randomised trial. BMJ 1996;313:1180–4Google Scholar
22Uhari, M, Kontiokari, T, Niemela, M. A novel use of xylitol sugar in preventing acute otitis media. Pediatrics 1998;102:879–84Google Scholar
23Tapiainen, T, Luotonen, L, Kontiokari, T, Renko, M, Uhari, M. Xylitol administered only during respiratory infections failed to prevent acute otitis media. Pediatrics 2002;109:E19Google Scholar
24Hautalahti, O, Renko, M, Tapiainen, T, Kontiokari, T, Pokka, T, Uhari, M. Failure of xylitol given three times a day for preventing acute otitis media. Pediatr Infect Dis J 2007;26:423–7Google Scholar
25Otitis Media with Effusion – ENT Management. International View. Map of Medicine, 2011 In: http://mapofmedicine.com [17 August 2013]Google Scholar
26Centre for Clinical Practice at NICE. Surgical management of otitis media with effusion in children. NICE clinical guideline 60. London: National Institute for Health and Clinical Excellence, 2008Google Scholar
27Institute for Clinical Systems Improvement. Diagnosis and treatment of otitis media in children. Bloomington, Minnesota: Institute for Clinical Systems Improvement, 2008Google Scholar
28Otitis media with effusion, version 1.0, 2007. Clinical Knowledge Summaries. In: http://cks.nice.org.uk/otitis-media-with-effusion [17 August 2013]Google Scholar
29Morris, P. Chronic suppurative otitis media. Clin Evid 2012;8:507Google Scholar
30Chronic suppurative otitis media. DynaMed online database, EBSCO Information Services, 2013. In: http://web.b.ebscohost.com/dynamed/detail?sid=9a0ae354-fdb2-4750-84bb-f728b6455d67%40sessionmgr110&vid=1&hid=110&bdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU%3d#db=dme&AN=113635 [17 August 2013]Google Scholar
31Browning, GG, Gatehouse, S, Calder, IT. Medical management of active chronic otitis media: a controlled study. J Laryngol Otol 1988;102:491–5Google Scholar
32Picozzi, G, Browning, G, Calder, I. Controlled trial of gentamicin and hydrocortisone ear drops in the treatment of active chronic otitis media. Clin Otolaryngol 1983;8:367–8Google Scholar
33Crowther, JA, Simpson, D. Medical treatment of chronic otitis media: steroid or antibiotic with steroid ear-drops? Clin Otolaryngol 1991;6:142–4Google Scholar
34Kaygusuz, I, Karlidağ, T, Gök, U, Yalçin, S, Keleş, E, Demirbağ, E et al. Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media [in Turkish]. Kulak Burun Bogaz Ihtisas Derg 2002;9:106–11.Google Scholar
35Miro, N. Controlled multicenter study on chronic suppurative otitis media treated with topical applications of ciprofloxacin 0.2% solution in single-dose containers or combination of polymyxin B, neomycin, and hydrocortisone suspension. Otolaryngol Head Neck Surg 2000;23:617–23Google Scholar
36Macfadyen, CA, Acuin, JM, Gamble, C. Systemic antibiotics versus topical treatments for chronically discharging ears with underlying eardrum perforations. Cochrane Database Syst Rev 2006;(1):CD005608.Google Scholar
37Browning, GG, Picozzi, GL, Calder, IT, Sweeney, G. Controlled trial of medical treatment of active chronic otitis media. BMJ 1983;287:1024Google Scholar
38Esposito, S, D'Errico, G, Montanaro, C. Topical and oral treatment of chronic otitis media with ciprofloxacin. Arch Otolaryngol Head Neck Surg 1990;116:557–9Google Scholar
39Esposito, S, D'Errico, G, Mantanaro, C. Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media. Arch Otolaryngol Head Neck Surg 1992;118:842–4Google Scholar
40Povedano Rodríguez, V, Seco Piñero, MJ, Jurado Ramos, A, López Villarejo, P. Efficacy of topical ciprofloxacin in the treatment of chronic otorrhea [in Spanish]. Acta Otorrinolaringol Esp 1995;46:15–18Google Scholar
41Yuen, PW, Lau, SK, Chau, PY, Hui, Y, Wong, SF, Wong, S et al. Ofloxacin eardrop treatment for active chronic suppurative otitis media: prospective randomized study. Am J Otol 1994;15:670–3Google Scholar
42Legent, F, Bordure, P, Beauvillain, C, Berche, P. Controlled prospective study of oral ciprofloxacin versus amoxicillin/clavulanic acid in chronic suppurative otitis media in adults. Chemotherapy 1994;40(suppl 1):16–23Google Scholar
43Cannoni, M, Bonfils, P, Sednaoui, P, Sevenier, F, Joubert-Collin, M, Nisse, DS. Cefotiam hexetil versus amoxicillin/clavulanic acid for the treatment of chronic otitis media in adults. Med Mal Infect 1997;27:915–21Google Scholar
44Lildholdt, T, Felding, JU, Juul, A, Kristensen, S, Schouenborg, P. Efficacy of perioperative ceftazidime in the surgical treatment of chronic otitis media due to Pseudomonas aeruginosa. Arch Otorhinolaryngol 1986;243:167–9Google Scholar
45Picozzi, G, Browning, G, Calder, I. Controlled trial of gentamicin and hydrocortisone ear drops with and without systemic metronidazole in the treatment of active chronic otitis media. Clin Otolaryngol 1984;9:305Google Scholar
46Supiyaphun, P, Kerekhanjanarong, V, Koranasophonepun, J, Sastarasadhit, V. Comparison of ofloxacin otic solution with oral amoxycillin plus chloramphenicol ear drop in treatment of chronic suppurative otitis media with acute exacerbation. J Med Assoc Thai 2000;83:61–8Google Scholar
47Mira, E, Benazzo, M. Topical use of cephalosporins in the treatment of purulent otitis media: evaluation of ceftizoxima (Eposerin) [in Italian]. Rivista-Italiana-di-Otorinolaringologia-Audiologia-e-Foniatria 1992;12(4):219–25Google Scholar
48Macfadyen, CA, Acuin, JM, Gamble, C. Topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations. Cochrane Database Syst Rev 2005;(4):CD004618Google Scholar
49Tong, MC, Yue, V, Ku, PK, van Hasselt, CA. Preoperative topical ofloxacin solution for tympanoplasty: a randomized, controlled study. Otol Neurotol 2002;23:18–20Google Scholar
50Bhat, KV, Naseeruddin, K, Nagalotimath, US, Kumar, PR, Hegde, JS. Cortical mastoidectomy in quiescent, tubotympanic, chronic otitis media: is it routinely necessary? J Laryngol Otol 2009;123:383–90Google Scholar
51Fliss, DM, Dagan, R, Houri, Z, Leiberman, A. Medical management of chronic suppurative otitis media without cholesteatoma in children. J Pediatr 1990;116:991–6Google Scholar
52Somekh, E, Cordova, Z. Ceftazidime versus aztreonam in the treatment of pseudomonal chronic suppurative otitis media in children. Scand J Infect Dis 2000;32:197–9Google Scholar
53Van Hasselt, P. Treatment of chronic suppurative otitis media with suction cleaning and antiseptic versus antibiotic ear drops. Internal Report of Christian Blind Mission International. Bensheim, Germany; Christian Blind Mission International, 1997Google Scholar
54Leach, A, Wood, Y, Gadil, E, Stubbs, E, Morris, P. Topical ciprofloxin versus topical framycetin gramicidin-dexamethasone in Australian aboriginal children with recently treated chronic suppurative otitis media: a randomized controlled trial. Pediatr Infect Dis J 2008;27:692–8Google Scholar
55Thorp, MA, Gardiner, IB, Prescott, CA. Burow's solution in the treatment of active mucosal chronic suppurative otitis media: determining an effective dilution. J Laryngol Otol 2000;114:432–6Google Scholar
56Eason, RJ, Harding, E, Nicholson, R, Nicholson, D, Pada, J, Gathercole, J. Chronic suppurative otitis media in the Solomon Islands: a prospective microbiological, audiometric and therapeutic survey. N Z Med J 1986;99:812–15Google Scholar
57Macfadyen, C, Gamble, C, Garner, P, Macharia, I, Mackenzie, I, Mugwe, P et al. Topical quinolone vs antiseptic for treating chronic suppurative otitis media: a randomized controlled trial. Trop Med Int Health 2005;10:190–7Google Scholar
58Smith, AW, Hatcher, J, Mackenzie, IJ, Thompson, S, Bal, I, Macharia, I et al. Randomised controlled trial of treatment of chronic suppurative otitis media in Kenyan schoolchildren. Lancet 1996;348:1128–33Google Scholar
59Cholesteatoma. DynaMed online database EBSCO Information Services, 2013. In: http://web.a.ebscohost.com/dynamed/detail?vid=2&sid=8e21a656-a537-4fe7-a1e4-c70a2b31a503%40sessionmgr4001&hid=4209&bdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU%3d#db=dme&AN=115151 [17 August 2013]Google Scholar
60Neumann, C, Yung, M. Management of Retraction Pockets of Pars Tensa and Pars Flaccida: A Systematic Review of Literature. The Journal of International Advanced Otology 2012;8:360–65Google Scholar
61Neumann, C, Yung, M. A consensus based practical guide on the management of retraction pockets of pars tensa and pars flaccida. The Journal of International Advanced Otology 2013;9:12–15Google Scholar
62Lieberthal, AS, Carroll, AE, Chonmaitree, T, Ganiats, TG, Hoberman, A, Jackson, MA et al. The diagnosis and management of acute otitis media. Pediatrics 2013;131:964–99Google Scholar