***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: OBJECTIVES To compare different treatment regimens of  chronic suppurative otitis media ( CSOM ) in school children , in regard to their consequence in hearing and discharge from the ear drum perforation . DESIGN R and omised controlled trial . SETTING R and omly selected primary schools within Dar es Salaam . SUBJECTS Three hundred and twenty eight children between 5 - 17 years of age with CSOM in one or both ears . RESULTS Three to four months after the onset of treatment 31 % of group 1 , 54 % of group 2 , and 56 % of group 3 , had dry ears . Treatment with dry mopping and boric acid in alcohol ear drops  was significantly better than dry mopping alone . Adding amoxicillin to the treatment did not improve the end results . Hearing test performed before and after treatment showed that the hearing thresholds were the same or better after the treatment . The possible risk that boric acid in alcohol ear drops should lead to sensorineural hearing loss has not been confirmed . CONCLUSION Based on the above results , the treatment of choice for CSOM in children in Dar es Salaam should be dry mopping and boric acid in spirit ear drops Background Chronic suppurative otitis media ( CSOM ) is frequently associated with symptoms of inflammation like discharge from the ear or pain . In many cases , patients suffer from hearing loss causing communication problems and social withdrawal . The objective of this work was to collect prospect i ve audiological data and data on general and disease-specific quality of life with vali date d quality of life measurement instruments to assess the impact of the disease on health-related quality of life ( HR-QOL ) . Methods 121 patients were included in the study . Patients were clinical ly examined in the hospital before and 6 months after surgery including audiological testing . They filled in the quality of life question naires SF-36 and Chronic Otitis Media Outcome Test 15 ( COMOT-15 ) pre-operatively and 6 and 12 months post-operatively , respectively . Results Complete data records from 90 patients were available for statistical analysis . Disease-specific HR-QOL in patients with CSOM improved after tympanoplasty in all the scales of the COMOT-15 . There was no difference in HR-QOL assessment between patients with mesotympanic respectively epitympanic CSOM . However , we did find the outcome to be worse in patients who received revision surgery compared with those receiving primary surgery . Audiometric findings correlated very well with the subscale hearing function from the COMOT-15 question naire . General HR-QOL measured with the SF-36 was not significantly changed by tympanoplasty . Conclusions Tympanoplasty did lead to a significant improvement of disease-specific HR-QOL in patients with CSOM while general HR-QOL did not change . Very well correlations were found between the subscale hearing function from the COMOT-15 question naire and audiological findings . Revision surgery seems to be a predictor for a worse outcome We conducted a test of the efficacy of ciprofloxacin eardrops in 80 patients ( 95 ears ) with otorrhea due to chronic suppurative otitis media in two treatment setting s. One group ( n=40 ; 47 ears ) received daily ciprofloxacin therapy plus aspiration in the clinic . The other group ( n=40 ; 48 ears ) self-administered ciprofloxacin at home . Overall , otorrhea resolved in 88 % of all ears within 12 days of the initiation of treatment . The clinic-treated patients tended to respond more rapidly than did the self-treated patients , but there was no statistically significant difference in success rates between the two groups . Side effects were negligible . We conclude that empiric topical ciprofloxacin therapy is an effective , safe and relatively inexpensive treatment for otorrhea in patients with chronic otitis media OBJECTIVE To evaluate the efficacy of ciprofloxacin compared with tobramycin and placebo ear drops in the treatment of chronic suppurative otitis media without cholesteatoma . DESIGN Sixty ears ( in 51 patients ) were r and omly divided into 3 treatment groups : ciprofloxacin hydrochloride , tobramycin , and placebo interventions . SETTING The otolaryngology department of a university teaching hospital . INTERVENTION All ears were treated topically for 3 weeks . MAIN OUTCOME MEASURES Each patient received a small , numbered bottle and was instructed to instill 5 drops 3 times daily for 3 weeks . The final clinical and bacteriologic assessment was made after 3 weeks . RESULTS The organism most commonly isolated from the ear discharge was Pseudomonas aeruginosa . Its sensitivity to ciprofloxacin and tobramycin was 94.2 % and 70.6 % , respectively . The clinical response was 78.9 % , 72.2 % , and 41.2 % in the ciprofloxacin , tobramycin , and placebo groups , respectively . The bacteriologic response rate was 66.7 % for the ciprofloxacin and tobramycin groups and 20 % for the placebo group . Treatment with ciprofloxacin ear drops seemed to be as effective as treatment with tobramycin . CONCLUSION While the lack of ototoxicity of ciprofloxacin was not tested in our study , this treatment may be considered as a potential topical therapy for cases of chronic suppurative otitis media Abstract Chronic otitis media is persistent and insidious disease . It is one of the most common bacterial infections in the field of otolaryngology having significant economic and individual repercussion . Medical management of chronic suppurative otitis media ( CSOM ) for dry ear is essential before surgical treatment . The objective is to consider the most appropriate medical treatment modalities for patients of CSOM . To assess results of acetic acid irrigation and topical and systemic antibiotic in CSOM and consider , the most appropriate medical management . This study was conducted prospect ively from Nov 2011 to Sep 2013 in 100 patients of CSOM ( tubotympanic type ) . Patient included in the present study were divided in two groups . In one group patients were treated with aural toilet and irrigation with acetic acid and in other group patients were treated with topical and systemic antibiotic . After a follow up period of 3 months duration results were assessed on the basis of absence of discharge , healing of perforation and status of middle ear . Otorrhoea resolution in group treated with acetic acid was 84 % and healing of perforation was noted in 26 % while failure rate of 16 % was noted . In group treated with topical and systemic antibiotic 58 % of patient shows otorrhoea resolution , 14 % achieve healing of perforation and 32 % had failure . Medical management of CSOM without Cholesteatoma by frequent aural cleaning and irrigation using dilute acetic acid can be more desirable choice as compared to the topical and oral antibiotics SUMMARY The role of corticosteroid in patients of chronic suppurative otitis media ( CSOM ) is unknown . In the present study , the efficacy and safety of ofloxacin alone ( OA ) and the ofloxacin + dexamethasone combination ( ODC ) is compared by study ing clinical cure rates and adverse drug reactions in patients with CSOM . After prior permission from the Institutional Review Board and written informed consent from patients , pre-treatment clinical assessment and bacteriology of the middle ear discharge were done . The middle ear was categorised into active , mucoid or inactive according to the type of discharge . Grade s of otorrhoea and size of tympanic membrane perforation were noted . CSOM with organisms sensitive to ofloxacin were treated either with OA or ODC eardrops for a period of 15 days . Post-treatment clinical cure ( when grade of otorrhoea become 0 ) was recorded on the 5th , 10th and 15th days and bacteriological assessment was recorded at the last visit . All parameters were analysed using Fisher 's exact test . A total 110 patients were r and omised . The most common microorganism associated with CSOM was Pseudomonas aeruginosa ( 45.45 % ) . Clinical improvement was seen in 84.61 % and 86.79 % of cases , but bacteriological improvement in only 82.69 % and 77.35 % of cases treated with OA and ODC , respectively . Shift of middle ear discharge from active to inactive was noted in 71.15 % and 64.15 % patients by the 10th day in the OA and ODC groups , respectively . As there was no difference in clinical or bacteriological improvement , it may be unnecessary to combine steroids with topical antibiotic preparations for management of CSOM OBJECTIVES To compare the effectiveness of ototopical ciprofloxacin ( 0.3 % ; CIP ) with framycetin ( 0.5 % ) , gramicidin , dexamethasone ( FGD ) eardrops ( 5 drops twice daily for 9 days ) together with povidone-iodine ( 0.5 % ) ear cleaning as treatments for chronic suppurative otitis media ( CSOM ) in Aboriginal children . DESIGN AND PARTICIPANTS Aboriginal community-controlled , community-based , multicentre , double-blind , r and omised controlled trial in eight Aboriginal Community Controlled Health Services across northern Australia , involving 147 Aboriginal children with CSOM . MAIN OUTCOME MEASURES Resolution of otorrhoea ( clinical cure ) , proportion of children with healed perforated tympanic membrane ( TM ) and improved hearing , 10 - 21 days after starting treatment . RESULTS 111 children aged 1 - 14 years ( CIP , 55 ; FGD , 56 ) completed treatment . CSOM cures occurred in 64 % ( CIP , 76.4 % ; FGD , 51.8 % ) , with a significantly higher rate in the ciprofloxacin group ( P = 0.009 , absolute difference of 24.6 % [ 95 % CI , 15.8%-33.4 % ] ) . TM perforation size and the level of hearing impairment did not change . Pseudomonas aeruginosa was the most common bacterial pathogen ( in 47.6 % ) , while respiratory pathogens were rare ( in 5.7 % ) . CONCLUSIONS Twice-daily ear cleaning and topical ciprofloxacin is effective at community-level in achieving cure for CSOM . Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment OBJECTIVES To evaluate if povidone-iodine ( PVP-I ) can be used topically in the treatment of chronic suppurative otitis media-tubotympanic disease and to compare it with ciprofloxacin hydrochloride ear drops . DESIGN Prospect i ve double-blind r and omized study . SETTING Academic tertiary medical center . PATIENTS Forty patients with chronic suppurative otitis media were r and omized 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 aeruginosa . In vitro resistance to ciprofloxacin was seen in 17 % of organisms , while 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 topical agent in the treatment of chronic suppurative otitis media . The results show that clinical ly , 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 Most of the topical otic preparations have been shown to cause ototoxicity . In this study ciprofloxacin hydrochloride , a relatively new topical agent , and gentamicin sulfate were studied in two groups of 20 patients with chronic otitis media . Patients were r and omly selected to receive either ciprofloxacin ( 200 μg/ml ) or gentamicin sulfate ( 5 mg/ml ) locally , five drops three times a day for 10 days . Clinical response was seen in 20 of 20 patients in the ciprofloxacin group compared with 6 of 20 patients in the gentamicin group . Audiometric evaluation revealed no significant ototoxic effect in either group . In fact , hearing thresholds were slightly better than pretreatment levels in both groups This report presents a prospect i ve r and omized study of 0.3 percent ofloxacin eardrops for the treatment of  active chronic suppurative otitis media . Twenty-nine patients were treated with ofloxacin eardrops for 1 week , and another 27 patients were treated with Augmentin for 1 week . One week after completion of treatment , 22 ( 76 % ) patients of the group treated with ofloxacin had dry ears , and only seven ( 26 % ) patients treated with Augmentin had dry ears .  Ofloxacin eardrops were effective in the initial treatment of active chronic suppurative otitis media Objective Method ological criteria that characterise ethically 
    Output:
    
Due to paucity of the evidence and the very low certainty of that which is available the effectiveness and safety profile of antiseptics in the treatment of CSOM is uncertain