Chronic suppurative otitis media

BMJ Clin Evid. 2007 Feb 1:2007:0507.


Introduction: Chronic suppurative otitis media (CSOM) is a common cause of hearing impairment, disability, and poor scholastic performance, and can occasionally lead to fatal intracranial infections and acute mastoiditis, especially in resource-poor countries.

Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for chronic suppurative otitis media in adults; and in children? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

Results: We found 48 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: ear cleansing, systemic antibiotics, topical antibiotics, topical antiseptics, topical corticosteroids, tympanoplasty (with or without mastoidectomy).

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Administration, Oral
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use
  • Chronic Disease*
  • Humans
  • Otitis Media, Suppurative* / drug therapy
  • Tympanoplasty


  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local