Evaluation of topical povidone-iodine in chronic suppurative otitis media

Objectives: To evaluate if povidone-iodine (PVP-1) can be used topically in the treatment of chronic suppurative otitis media-tubotympanic disease and to compare it with ciprofloxacin hydrochloride ear drops. Design: Prospective double-blind randomized study. Setting: Academic tertiary medical center. Patients: Forty patients with chronic suppurative ottis media were randomized into 2 groups. Intervention: One group (19 patients) received 5% PVP-I ear drops, while the other group (21 patients) received 0.3% ciprofloxacin ear drops. Both were administered topically, 3 drops 3 times daily for 10 days. These patients were followed up at weekly intervals for up to 4, weeks after commencing therapy. Results: Clinical improvement at the end of study was 88% in the PVP-I group and 90% in the ciprofloxacin group. The most commonly isolated organism was Pseudomonas acruginosa. In vitro resistance to ciprofloxacin was seen in 17% of organisms, where no resistance was seen for PVP-I. Conclusions: To our knowledge this is the first study to evaluate the efficacy of PVP-I as a typical agent in the treatment of chronic suppurative ottis media. The results show that clinically topical PVP-I is as effective as topical ciprofloxacin with a superior advantage of having no in vitro drug resistance. Also, there is an added benefit of reduced cost of therapy.