A Cochrane review [Abstract] 1 included 15 RCTs with a total of 2476 children (from 4 months to 17 years). For a single application at surgery, the risk of otorrhoea was reduced at two weeks postoperatively by multiple saline washouts (from 30% to 16%; RR 0.52, 95% CI 0.27 to 1.00; NNTB 7; one RCT; n=140) and by antibiotic/steroid ear drops (from 9% to 1%; RR 0.13, 95% CI 0.03 to 0.57; NNTB 13; one RCT; 322 ears). A meta-analysis of two trials (222 ears) failed to find an effect of a single application of antibiotic/steroid ear drops at 4 to 6 weeks postoperatively.For a prolonged application of an intervention, there was evidence from 4 trials that the risk of otorrhoea was reduced two weeks postoperatively by antibiotic ear drops (from 15% to 8%; RR 0.54, 95% CI 0.30 to 0.97; NNTB 15; one RCT; n=372), antibiotic/steroid ear drops (from 39% to 5%; RR 0.13, 95% CI 0.05 to 0.31; NNTB 3; one RCT; n=200), aminoglycoside/steroid ear drops (from 15% to 5%; RR 0.37, 95% CI 0.18 to 0.74; NNTB 11; one RCT; n=356) or oral antibacterial agents/steroids (from 39% to 5%; RR 0.13, 95% CI 0.03 to 0.51; NNTB 3; one RCT; n=77).
Clinical comment: If topical drops are chosen, it is suggested that to reduce the cost and potential for ototoxic damage this be a single application at the time of surgery and not prolonged thereafter.
Primary/Secondary Keywords