Antibiotic prophylaxis in traumatic perforation of the tympanic membrane
Date First Published:
March 18, 2004
Last Updated:
August 11, 2009
Report by:
Samuel Guest, StR4 (Blackpool Victoria Hospital)
Search checked by:
Samuel Guest, Blackpool Victoria Hospital
Three-Part Question:
In patients with [traumatic perforation of the tympanic membrane] are [prophylactic antibiotics] indicated to [reduce the complication rate].
Clinical Scenario:
You are on duty in the Emergency Department when you see a 20 year old woman who has perforated her left tympanic membrane with a cotton bud. You wonder if the ENT SHO is right when he suggests prophylactic antibiotics.
Search Strategy:
Medline 1966 – 9/2/09. Using the OVID interface
[Tympanic membrane.mp OR Ear drum.mp OR exp.Tympanic membrane perforation]LIMIT to English AND Human
AND [antibiotics.mp OR exp.antibacterial agent]
[Tympanic membrane.mp OR Ear drum.mp OR exp.Tympanic membrane perforation]LIMIT to English AND Human
AND [antibiotics.mp OR exp.antibacterial agent]
Outcome:
244 papers found of which none were relevant
Author Commentary:
All studies of perforated TMs routinely used prophylactic antibiotics of some description.
Bottom Line:
There is no evidence comparing prophylactic antibiotics with no treatment and so local guidelines should be followed.