Topical versus systemic antibiotics for chronic suppurative otitis media

Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Systemic antibiotics are commonly used to treat people with CSOM. This is the first update to the review published in 2021, and is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.

Citation:
Chong LY, Head K, Webster KE, Daw J, Strobel NA, Richmond PC, Snelling T, Bhutta MF, Schilder AG, Brennan-Jones CG. Topical versus systemic antibiotics for chronic suppurative otitis media. Cochrane Database Syst Rev. 2025;6(6):Cd013053.

Keywords:
Antibacterial agents; administration; adverse effects; therapeutic use; chronic disease; drug therapy

Abstract:
Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Systemic antibiotics are commonly used to treat people with CSOM. This is the first update to the review published in 2021, and is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.