This protocol covers the treatment of chronic atticoantral suppurative otitis media in patients with chronic suppurative otitis media without suspected cholesteatoma, presenting with a dry ear — applicable to pediatric patients aged 6 months and older, and to adults.
Chronic suppurative otitis media without suspected cholesteatoma can be treated based on whether the ear is typically dry or wet. In the dry-ear presentation, the underlying pathogens resemble those found in acute otitis media, which directly informs the treatment strategy for this population.
The management of this presentation centres on topical otic therapy delivered directly to the affected ear. The treatment goal is resolution of otorrhea by three weeks of therapy. The specific agents, options, and complete regimen are detailed in the full protocol.
Chronic suppurative otitis media without suspected cholesteatoma can be treated based on whether the ear is typically dry or wet (chronic discharge).
Chronic suppurative otitis media with a dry ear is likely due to the same pathogens that cause acute otitis media and therefore can be treated with an antibiotic used to treat AOM.
Note that ciprofloxacin and dexamethasone otic solution (Ciprodex ™) is equally as effective as oral antibiotics with fewer systemic side effects.
Treatment is considered to have failed if otorrhea continues after three weeks of therapy.
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