Evaluation of topical 5% povidone iodine solution in chronic suppurative otitis media: a case series

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dc.contributor.advisorAdam, Shaunen_ZA
dc.contributor.authorBoggenpoel, Ashtonen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Otorhinolaryngology.en_ZA
dc.date.accessioned2023-02-13T08:16:36Zen_ZA
dc.date.accessioned2023-10-18T12:53:51Zen_ZA
dc.date.available2023-02-13T08:16:36Zen_ZA
dc.date.available2023-10-18T12:53:51Zen_ZA
dc.date.issued2023-03en_ZA
dc.descriptionThesis (MMed)--Stellenbosch University, 2023.en_ZA
dc.description.abstractENGLISH ABSTRACT: Introduction: Chronic otitis media (COM) is a major public health concern in developing and developed countries. Early detection and appropriate management of these cases are critical for minimising the complications associated with this disease. The gold standard treatment is quinolone eardrops with or without steroids. However, quinolone ear drops are expensive, not readily available in developing countries. Antiseptics provide broad-spectrum antibacterial and antifungal effects, are cost-effective, and reduce the likelihood of organisms developing resistance. Povidone (polyvinyl pyrrolidone)-iodine (PVP-I) has been widely utilised for numerous clinical applications on skin and mucosa for the past 30 years with no significant local or systemic side effects and is cost-effective. 5 Gram-positive and gram-negative bacteria, anaerobes, spores, mycobacteria, fungi, viruses, and protozoans are all susceptible to its broad antibacterial range.6 Aim: This case series aims to assess the efficacy of topically applied 5% povidone-iodine (PVP-I) in the treatment of active COM. This was measured as the resolution of active COM ears. Methods: The study design is a prospective case-controlled series. All subjects presenting to the otorhinolaryngology department with discharging ears and who met the inclusion criteria, were entered into the study. A total of 51 (39 subjects) ears were allocated to receive 5% PVPI. Six drops were administered twice daily to the affected ears. Subjects were followed up at four weeks after the initial consultation. During their review visit, an evaluation by microscopic examination was performed. Ears were graded as actively discharging (wet) deemed as failure or inactive (dry) deemed successful. This formed the main outcome measure. Outcomes: In this case series bidaily administration of 5% PVP-I solution led to a clinical improvement in 89.47% of ears, whereas 10.53 % of ears had treatment failure. This outcome was comparable to other studies using 5% PVP-I. Previous studies had more frequent consultations and aural toilets, while participants in this case only had two consultations and two aural toilets, yielding the same outcome. Conclusion: This study demonstrates that 5% PVP-I solution is an inexpensive and effective treatment for active COM. 5%PVI-I solution serves as an excellent alternative in resource limited settings where quinolone ear drops are not widely available. In the South African context, in particular the public health care system, this may translate to reduced healthcare costs and an equally effective treatment option when quinolone eardrops are not readily available.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Inleiding: Kroniese otitis media (COM) is een van die belangrikste openbare gesondheidskwessies in beide veral-delete ontwikkelende en ontwikkelde lande. Vroeë identifikasie en behoorlike hantering van hierdie gevalle is van kardinale belang, veral om komplikasies wat met hierdie siekte geassosieer word te voorkom. Die goue standaard behandeling is kinoloon oordruppels met of sonder steroïede. Kinoloon oordruppels is egter duur en nie geredelik beskikbaar in ontwikkelende lande nie. Antiseptika bied 'n wye spektrum antibakteriese en antifungale effekte en is koste-effektief. Weerstand deur organismes teen antiseptika is minder geneig om te ontwikkel. Doelstelling: Hierdie gevallereeks het ten doel om die doeltreffendheid van plaaslik toegediende 5% povidoon-jodium (PVP-I) in die behandeling van aktiewe COM te assesseer. Suksesvolle behandeling is as die resolusie van aktiewe COM gemeet. Metodes: Die studie-ontwerp is 'n voornemende geval-beheerde reeks. Alle proefpersone wat aan die otorhinolaringologie-afdeling presenteer het met ore wat dreineer het en aan die insluitingskriteria voldoen het, is in die studie ingeskryf. Altesaam 51 (39 deelnemers) ore is toegeken om 5% PVP-I te ontvang. Ses druppels is twee keer per dag in die aangetaste oor toegedien. Proefpersone is vier weke na die aanvanklike konsultasie opgevolg. Tydens hul opvolg besoek is 'n mikroskopiese ondersoek van die oor gedoen, en grader en noteer as aktief dreinerend (nat) of onaktief (droog) . Dit het die hoof uitkomsmaatstaf gevorm. (moet noem dat droog suksesvol is) Resultate: In hierdie gevalle reeks het tweedaagse toediening van 5% PVP-I oplossing gelei tot 'n kliniese verbetering in 89.47% van die ore, terwyl 10.53% van die ore behandeling gefaal het. Hierdie uitkoms was vergelykbaar met ander studies wat ook 5% PVP-I as behandelings opsies gebruik het. Vorige studies het meer gereelde konsultasies en oortoilette gehad, terwyl deelnemers in hierdie reeks slegs twee konsultasies en twee oortoilette gehad het, met dieselfde uitkomste . Gevolgtrekkinge: Hierdie studie demonstreer dat 5% PVP-I oplossing 'n goedkoop en effektiewe behandeling vir aktiewe COM is. 5% PVI-I oplossing dien as 'n uitstekende alternatief in hulpbronbeperkte (publieke) omgewings waar kinoloon-oordruppels nie algemeen beskikbaar is nie. In die Suid-Afrikaanse kontek kan dit lei tot verlaagde gesondheidsorgkostes en 'n meer effektiewe behandelingsopsie wanneer kinoloon-oordruppels nie geredelik beskikbaar is nie.af_ZA
dc.description.versionMastersen_ZA
dc.format.extentv, 48 pagesen_ZA
dc.identifier.urihttps://scholar.sun.ac.za/handle/10019.1/128645en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subject.lcshOtitisen_ZA
dc.subject.lcshQuinolone antibacterial agentsen_ZA
dc.subject.lcshChronic diseases -- Treatmenten_ZA
dc.subject.lcshPovidone-iodine -- Effectivenessen_ZA
dc.subject.lcshPublic health -- Developing countriesen_ZA
dc.subject.lcshOtolaryngologyen_ZA
dc.titleEvaluation of topical 5% povidone iodine solution in chronic suppurative otitis media: a case seriesen_ZA
dc.typeThesisen_ZA
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