Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new cortisporin research articles will be listed here shortly after becoming available to us.
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Medical research on cortisporin
Curr Med Res Opin. 2006 Sep; 22(9): 1725-36
Schwartz RH
INTRODUCTION: Otitis externa (OE) is an infection of the external auditory canal affecting children and adults and is associated with symptoms of local pain and tenderness. Twice-daily topical treatment with ofloxacin otic solution (0.3% [Floxin otic solution]) for 10 days has been reported to be as effective and well tolerated as neomycin sulfate/polymyxin B sulfate/hydrocortisone otic suspension (Cortisporin otic suspension) administered four times daily for 10 days. OBJECTIVE: This study compared the efficacy, safety, and ear-pain resolution of once-daily ofloxacin otic solution (0.3%) versus neomycin sulfate/polymyxin B sulfate/hydrocortisone otic suspension administered four times daily, in children with OE. RESEARCH DESIGN, PATIENTS, AND METHODS: This multicenter, randomized, parallel-group, evaluator-blinded study was conducted at 34 centers in 278 pediatric OE patients aged 6 months to 12 years. Patients received five drops of ofloxacin otic solution (0.3%) in the affected ears once daily or three drops of neomycin sulfate/polymyxin B sulfate/hydrocortisone otic suspension four times daily, for 7-10 days. Patient evaluations were performed at pretherapy (day 1), end of therapy (days 7-9), and test of cure (7-10 days post-treatment) visits. Data for 208 patients were clinically evaluable and those for 90 patients were microbiologically evaluable. Scores were obtained for patient assessments of pain severity. MAIN OUTCOME MEASURES: The overall clinical response was cure in the clinically evaluable patients, demonstrated by resolution of OE signs and symptoms at the test of cure visit. The overall clinical-microbiological response was cure in the microbiologically evaluable patients demonstrated by both clinical cure and microbiological eradication. RESULTS: For the clinically evaluable patients, equivalent cure rates were obtained between the once-daily ofloxacin-treated and four-times-daily neomycin sulfate/polymyxin B sulfate/hydrocortisone-treated patients (93.8% and 94.7%, respectively). For the clinically and microbiologically evaluable patients, the overall cure rates were 96.4% versus 97.1% for the ofloxacin-treated and neomycin sulfate/polymyxin B sulfate/hydrocortisone-treated patients, respectively. The eradication rates for the prevalent pathogen, Pseudomonas aeruginosa, were 98% versus 100% for ofloxacin-treated and neomycin sulfate/polymyxin B sulfate/hydrocortisone-treated patients, respectively. Decreases in pain severity were similar in both treatment groups. Statistical analyses were limited by the small numbers of patients in each treatment group. CONCLUSION: In the treatment of OE in children, once-daily ofloxacin otic solution was as effective and safe as neomycin sulfate/polymyxin B sulfate/hydrocortisone otic suspension given four times daily. The two treatments provide rapid and comparable pain relief; however, ofloxacin otic solution does not have the risk of ototoxicity associated with neomycin and provides effective pain relief without adjunctive steroids.
Gen Dent. 2006 Jul-Aug; 54(4): 258-61
Percinoto C, de Castro AM, Pinto LM
This study utilized clinical and radiographic examinations to compare the effectiveness of calcium hydroxide paste and mineral trioxide aggregate (MTA) for pulpotomies of primary molars in children. Ninety primary molars that showed clinical and radiographic indications for pulpotomy treatment were selected. The pulpotomies were performed in two sessions, using a corticosteroid/antibiotic solution as therapeutic dressing. The sample was divided into two groups of 45 teeth, in which the pulpal remains were protected with either calcium hydroxide paste (Group 1) or MTA (Group 2). Radiographs were taken immediately and at 3-, 6-, and 12-month follow-up appointments. Three teeth in Group 1 failed after three months, while two cases failed after six months and one more failed at one year. Two failures were found in Group 2 at the 12-month follow-up. These results indicate that both materials may be utilized for pulpotomies in primary teeth.
Topical otic antibiotics: clinical cochlear ototoxicity and cost consideration.
Otolaryngol Head Neck Surg. 2006 Aug; 135(2): 291-4
Berenholz LP, Burkey JM, Farmer TL, Lippy WH
OBJECTIVE: Determine the incidence of clinical cochlear ototoxicity in routine use of Cortisporin after ventilation tube placement. Cost differential between use of Cortisporin and fluoroquinolone agents was evaluated. METHODS: A retrospective review of 500 patients was performed. Cortisporin otic suspension was used for 5 days following ventilation tube insertion. RESULTS: Testing following surgery indicated a sensorineural hearing loss (SNHL) in 19 (2.1%) ears. The SNHL existed prior to the surgery and there was no deterioration in the hearing postoperatively. The total cost for our study group who used Cortisporin was $15,500. If Floxin had been prescribed the cost would have been $45,000. Had Ciprodex been prescribed, the cost would have been $49,500. CONCLUSION: Our study demonstrates no clinical cochlear ototoxicity in children who received Cortisporin following ventilation tube placement. The cost differential for prescribing fluoroquinolone drops is significant. EBM rating: C-4.
Interventions for ear discharge associated with grommets (ventilation tubes).
Cochrane Database Syst Rev. 2006; CD001933
Vaile L, Williamson T, Waddell A, Taylor G
BACKGROUND: The insertion of grommets (also known as ventilation or tympanostomy tubes) is one of the most common surgical procedures performed on children. Postoperative otorrhoea (discharge) is the most common complication with a reported incidence ranging from 10% to 50%. In the UK, many ENT surgeons treat with topical antibiotics/steroid combinations, but general practitioners, mainly through fears of ototoxicity, are unlikely to prescribe these and choose systemic broad-spectrum antibiotics. OBJECTIVES: 1. To identify the most effective non-surgical management of discharge from ears with grommets in place.2. To identify the risks of non-surgical management for this condition (e.g. ototoxicity), and to set benefits of treatment against these risks. SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1, 2005), MEDLINE (1966 to 2005) and EMBASE (1974 to 2005). We also searched the CINAHL, AMED, LILACS, ISI WEB OF KNOWLEDGE, ISI PROCEEDINGS, mRCT, NNR, ZETOC, KOREAMED, CSA, MEDCARIB, INDMED and SAMED databases. The date of the last search was February 2005. SELECTION CRITERIA: Randomised controlled trials of adults or children, with any type of grommet and an ear with discharge were included. The trials compared treatment with placebo or one treatment with another. The primary outcome measure was the duration of the discharge. DATA COLLECTION AND ANALYSIS: The trials were selected independently according to the above criteria by the four reviewers. Differences in opinion over the inclusion of studies were resolved by discussion. The studies were graded using the CASP critical appraisal tool. Analyses were based on the presence of discharge seven days from the onset of treatment. MAIN RESULTS: There was very little good quality evidence. Four studies were included, all of them investigating different interventions and therefore a meta-analysis was not possible.Only one study demonstrated a significant difference. Oral amoxicillin clavulanate was compared to placebo in 79 patients. The odds of having a discharge persisting eight days after starting treatment was 0.19 (95% CI 0.07 to 0.49) . The number needed to treat to achieve that benefit is 2.5. Participants in both arms of this study also received daily aural toilet. The results will therefore not be applicable to most settings including primary care.No significant benefit was shown in the two studies investigating steroids (oral prednisolone with oral amoxicillin clavulanate and topical dexamethasone with topical ciprofloxacin ear drops), or the one study comparing an antibiotic-steroid combination (Otosporin(R)) drops versus spray (Otomize(R)) (although more patients preferred the spray form). AUTHORS' CONCLUSIONS: The authors of this review have been unable to identify the most effective intervention or to assess the associated risks. Research is urgently needed into the effectiveness of oral versus topical antibiotics in this group of patients. Clinicians considering antibiotic treatment need to balance any potential benefit against the risks of side effects and antibiotic resistance.
Arch Otolaryngol Head Neck Surg. 2005 Sep; 131(9): 782-4
Al-Shawwa BA, Wegner D
OBJECTIVE: To report our experience in identification and treatment of acute otitis media (AOM) with otorrhea secondary to community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), which is seen in children at increasing rates. DESIGN: Clinical and laboratory records were retrospectively reviewed between January 2003 and December 2003. SETTING: Primary pediatric clinic. PATIENTS: Six pediatric patients who had AOM with otorrhea caused by CA-MRSA. MAIN OUTCOME MEASURES: Clinical resolution of AOM with otorrhea. RESULTS: All patients had acute-onset otorrhea associated with their AOM. Five patients had tympanostomy tubes and 1 had perforation of the tympanic membrane. None of the patients were responding to treatment with oral antibiotics (amoxicillin sodium-clavulanate potassium, cefpodoxime proxetil, and cefprozil) or fluoroquinolone ear drops (ofloxacin, ciprofloxacin). Specimens were obtained from the ears for cultures, and MRSA was present in the cultures. The organisms were resistant to levofloxacin and erythromycin in all patients and resistant to clindamycin hydrochloride in 2 patients. The cultures were sensitive to trimethoprim-sulfamethoxazole, gentamicin sulfate, rifampin, and vancomycin hydrochloride. All patients were treated successfully with oral trimethoprim-sulfamethoxazole and ear drops (gentamicin sulfate or polymyxin B sulfate-neomycin sulfate-hydrocortisone [Cortisporin]). CONCLUSIONS: The rising rate of CA-MRSA as a cause for many pediatric infections is a major concern. It is very important to obtain cultures from patients with nonresponsive or persistent otorrhea with AOM to look for MRSA and determine the sensitivity of the pathogen to antibacterial therapy. Trimethoprim-sulfamethoxazole is a good choice for initial, empirical therapy when combined with a topical agent for AOM with otorrhea if CA-MRSA is suspected. Further studies are needed to determine whether there is a link between the overuse of topical fluoroquinolones in pediatric patients and the recent rising rate of CA-MRSA.
Natural medicaments in endodontics -- a comparative study of the anti-inflammatory action.
Braz Oral Res. 2004 Apr-Jun; 18(2): 174-9
Silva FB, Almeida JM, Sousa SM
The objective of this study was to evaluate the irritant potential of propolis, Casearia sylvestris, Otosporin and saline solution (control). Twenty-eight male Wistar rats were selected, anesthetized and four experimental sites were designed on their backs. Injections of 2% Evans blue were intravenously administered in the lateral caudal vein and 0.1 ml of the tested solutions was injected intradermally into the experimental sites. The animals were killed 1/2, 1, 3 and 6 hours after the injection of the solutions. Each piece of skin containing the lesion was immersed in formamide and incubated at 45 masculine C for 72 h. After filtration, optical density was measured in a spectrophotometer. Data were statistically analyzed by a 2-way non-parametric test. The highest values of extracted dye were observed at 3 hours characterizing a peak in the inflammatory process. Propolis was the least irritant solution. The natural medicaments tested in this study may be a valuable alternative for endodontic treatment.
Laryngoscope. 2004 May; 114(5): 850-4
Neher A, Nagl M, Appenroth E, Gstöttner M, Wischatta M, Reisigl F, Schindler M, Ulmer H, Stephan K
OBJECTIVE: The study's objective was to test the tolerability and efficacy of the endogenous antiseptic N-chlorotaurine (NCT) in comparison with a standard clinical treatment according to a phase IIb clinical trial protocol. STUDY DESIGN: The antimicrobial agent NCT was compared with the antibiotic component drops Otosporin (containing neomycin, polymyxin B, and hydrocortisone) for topical treatment of acute otitis externa in a randomized and rater-blinded clinical study. METHODS: Fifty patients suffering from acute otitis externa were divided into two groups according to a randomized list. The test group was treated with 1 mL of 1% aqueous NCT solution, the reference group with 1 mL of Otosporin. The substances were applied to the external ear canal at one daily session until the signs of infection disappeared. Efficacy and tolerability were evaluated daily by visual analogue scale and a six-step infection score. In addition, smears were analyzed to identify the causative pathogens. RESULTS: Both medications were equally well tolerated by the patients. The treatment was successful for all patients of the NCT group, whereas in one patient from the reference group, the infection did not disappear. The inflammation score improved more rapidly in the NCT group, which resulted in an earlier termination of the therapy. This difference became highly significant on days 4 to 7 (P
Determination of ototoxicity of common otic drops using isolated cochlear outer hair cells.
Laryngoscope. 2001 Dec; 111(12): 2105-8
Jinn TH, Kim PD, Russell PT, Church CA, John EO, Jung TT
OBJECTIVES: Otic drops are commonly used not only for otitis externa, but also for otorrhea in the presence of tympanostomy tubes or tympanic membrane perforations. Many studies have demonstrated the ototoxicity of common otic preparations such as Cortisporin otic drops (Monarch Pharmaceuticals, Bristol, TN). The purpose of this study was to assess the relative ototoxicity of common otic preparations by direct exposure to isolated cochlear outer hair cells (OHCs). METHODS: OHCs from adult chinchilla cochlea were exposed to standard bathing solution (control), acetic acid, Acetasol HC (Alpharma USPD Inc., Baltimore, MD), Gentacidin (CIBA Vision Ophthalmics, Atlanta, GA), and Tobradex (Alcon, Fort Worth, TX). The cells were observed using an inverted microscope, and the images were recorded in digital still-frame and video, and analyzed on the Image Pro-Plus 3.0 program (Media Cybernetics, Silver Spring, MD). RESULTS AND CONCLUSIONS: As measured by time to cell death and change in morphology of OHCs, acetic acid with or without hydrocortisone was most toxic to OHCs. Cortisporin was more cytotoxic than gentamicin and Tobradex.
Int J Pediatr Otorhinolaryngol. 2001 Nov 1; 61(2): 99-104
Morpeth JF, Bent JP, Watson T
Myringotomy and tube insertion, a common pediatric surgical procedure, is frequently complicated by purulent otorrhea. Many otolaryngologists routinely use topical antibiotics as prophylaxis against post-tympanostomy otorrhea. The aminoglycosides (neomycin sulfate, tobramycin and gentamicin) contained in commonly used topical antibiotics as well as components of the solutions have been shown to be ototoxic in animal studies. Although little reported evidence of ototoxicity in humans exists, sporadic reports of sensorineural hearing loss linked to topical antibiotic use do exist, and the potential for sensorineural hearing loss must be considered. The purpose of this study is to compare the rate of post-tympanostomy otorrhea in a double-blinded randomized trial using either topical Ciprofloxacin, with no reported ototoxicity, or Cortisporin as prophylaxis. One hundred patients (200 ears) between ages 7 months and 11 years with a diagnosis of recurrent otitis media or chronic otitis media undergoing tympanostomy tube insertion were randomized into two equal groups. Three drops of either drop A or B were placed into each ear at the time of tube insertion and then three times daily for 3 days. Patients were examined at 3 weeks and details of otorrhea were obtained. The rate of otorrhea was analyzed using chi-square. The overall rate of otorrhea was 39 ears (19.5%), 17 (17%) ears for the Cortisporin group and 22 (22%) for the Ciprofloxacin group. The difference in rate of otorrhea was not statistically significant (P=0.372, 95% confidence interval equals -6-16%). Our data suggest that topical Cortisporin offers no benefit over Ciprofloxacin for post-operative otorrhea prophylaxis. Therefore we recommend topical quinolone prophylaxis, which should eliminate concerns about ototoxicity, without sacrificing efficacy.
Cholesteatoma prevention by local treatment with vitamin A.
Otol Neurotol. 2001 Sep; 22(5): 576-8
Nageris BI, Grushko I, Feinmesser R
HYPOTHESIS: In view of the proven effectiveness of vitamin A for the treatment of hyperkeratosis, it was hypothesized that vitamin A may also be a feasible therapeutic option for cholesteatoma, which has similar histologic features. BACKGROUND: Cholesteatoma is a major cause of chronic ear disease, often requiring surgery. The recurrence rate may exceed 20%. Hyperkeratosis is a major sequela of tympanomastoid surgery, causing chronic ear hygiene problems. METHODS: The external auditory canals of 40 Mongolian gerbils were ligated to induce cholesteatomas. The ears were divided into three groups by type of treatment: group I, vitamin A drops (n = 40); group II, Cortisporin drops (n = 20); group III, no treatment (control subjects) (n = 20). Examination for the development and grade of cholesteatomas was performed after 9 months. RESULTS: Cholesteatomas developed in 26 ears (65%) of group I, 12 ears (60%) of group II, and 20 ears (100%) of group III. The differences were significant between groups I and III and groups II and III for both rate of cholesteatomas and severity of grade. There were no significant differences between groups I and II. CONCLUSION: Local treatment reduces the risk of cholesteatomas in ligated gerbilline ears. Cortisporin and vitamin A are equally effective as local treatments.