The role of rifampicin in the treatment of chronic suppurative otitis media

Abstract

Back ground: Chronic suppurative otitis media (CSOM) has been an important cause of middle ear disease. The bacterial flora found in chronic suppurative otitis media varies considerably. A number of studies used fluroquinolon derivatives especially group II of this drug, like ciprofloxacin
Objective: In this study there was a trial for evaluatation of the benefit of using oral rifampicin drug in the treatment of tubo- tympanic type of chronic suppurative otitis media in combination with ciprofloxacin.
Patient and methods: In Al-Kerama general hospital/ENT department in Wassit 200 patients were selected divided in to two equal groups (A&B) but only164 patients continue in the study, 88 patients in group A & 76 patients in group B.
Group B received the usual line of treatment in the form of oral ciprofloxacin& local (ciprofloxacin drops+ betamethason drops), while group A received the same drugs in addition to oral rifampicin. The dryness rate of the ears from discharge along six months & the recurrence rate after dryness & stopping treatment were studied. Also the laboratory results of the effect of rifampicin alone & in combination with ciprofloxacin on the bacterial growth in the culture media from ear discharge were studied.
Results: Its found that the use of rifampicin in combination with other drugs used enhance faster dryness that, The percentage of ears that became dry in the 1st week were 88% & 65% for group A & group B respectively, (significant difference) . While the dryness within the 2nd week & the rest of 1st month were5.7% & 4.5% for the group A, and 15.8% & 14.4 % for group B ( It was not significant).
While the recurrent rate & response to treatment after recurrence were 9% & 75% for group A against 22.3% & 52% for group B .(significant difference ).rifampicin was a safe drug & well tolerated by the patients.
Conclusion: Systemic drugs like rifampicin when used might enhance rapid dryness, decrees recurrence of discharge &give us better response to treatment after recurrence.