Therapeutic Effects of Ciprofloxacin Powder and Drops in Chronic Bacterial Middle Ear Infections: A Clinical Trial Study

Background: Among different factors, middle ear infections are the most common causes of referral to an otolaryngologist. Currently, ciprofloxacin drops are an effective treatment for middle ear infections. Objectives: The purpose of this study was to compare the therapeutic effects of ciprofloxacin drops and powder in chronic bacterial middle ear infections. Methods: The present randomized clinical trial was conducted at Ayatollah Rouhani Hospital in Babol, Iran. After suction clearance, the patients were randomly divided into two groups: the control group received ciprofloxacin drops and the case group received ciprofloxacin powder in the tympanic cavity. All patients were evaluated for improvement of symptoms after two weeks. Results: Of the 125 patients, 60 (48%) had bacterial infection. There were 30 patients in the control and the case groups equally. Ear manipulation results showed that only 16.67% of the subjects had ear manipulation in the drop group, while that was 43.33% in the powder group. The frequency of itching, swelling and discharge was not significantly different between the two groups before the treatment, but this difference was significant after the treatment, especially in pain, swelling, and discharge. Overall, Pseudomonas aeruginosa, Enterobacteriaceae spp. and Staphylococcus epidermidis were the most common bacteria grown in culture. Conclusions: Owing to the better and more effective impact of ciprofloxacin drops than ciprofloxacin powder in improving the symptoms of patients, the use of ciprofloxacin powder is not recommended as a treatment for chronic bacterial infection of the middle ear.