Role of Topical Acetic Acid in Comparison to Gentamicin for the Management of Chronic Suppurative Otitis Media

  • Kirti Vishwakarma Department of Pharmacology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad
  • Farhan Ahmad Khan Department of Pharmacology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad.
  • Sheikh Nizamuddin Department of ENT, Teerthanker Mahaveer Medical College & Research Centre, Moradabad.
  • Preeti Singh Department of Pharmacology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad.
  • Lalendra Yadav Department of Pharmacology, Muzaffarnagar Medical College & Research Centre, Muzaffarnagar.
Keywords: Chronic Suppurative Otitis Media, Gentamicin, Acetic Acid


Introduction: Chronic Suppurative Otitis Media (CSOM) is one of the diseases resistant to current antibiotics; persisting for more than two week; and capable of causing severe discharge, tympanic membrane perforation and deafness. This may cause distress and affect their quality of life and productivity.

Aims: To assess the role of topical Acetic Acid in comparison to Gentamycin for management of CSOM.

Methods: It was a Randomized, open label study. Patients diagnosed as CSOM (safe type) were randomly divided into two groups, group I - topical 1.5% Acetic acid and group II - topical 0.3% Gentamicin sulphate in a dose of three otic drops thrice daily. Follow up was done every week for two weeks and was compared on the basis of otological symptoms score.

Results: The mean difference of otological symptom score at day 7 and day 14 from baseline in Group I was 1.90±1.01 and 3.40±1.08; and in Group II 1.96±0.57 and 3.12±0.74; p<0.05. Among the study groups, reduction of otological symptom scores at day 7 (Group I =3.22±1, Group II=2.66±1.76; p=0.14) and at day 14 (Group I = 1.72±1.76, Group II= 1.50±1.79; p=0.56) respectively. Also, “Treatment success” seen in 46 (92%) patients in the Acetic acid group and 44 (88%) patients in Gentamicin sulphate group. Moreover, cost of the treatment for Acetic acid was 102.94 and for Gentamicin sulphate was Rs.160.25 per person.

Conclusion: Topical Acetic acid was found to be equally effective to Gentamicin sulphate for the treatment of CSOM.


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1. WHO. Chronic suppurative otitis media. Burden of illness and management options. 2004. (last accessed on Aug 4 2015)
2. Li MG, Hotez PJ, Vrabec JT, Donovan DT. Is Chronic Suppurative Otitis Media a Neglected Tropical Disease? PLoSNegl Trop Dis. 2015 Mar; 9(3): e0003485.
3. Yorgancılar E, Yildirim M, Gun R, et al. Complications of chronic suppurative otitis media: a retrospective review. Eur Arch Otorhinolaryngol. 2013 Jan; 270(1):69-76.
4. Kumar N, Chilke D, Puttewar MP. Clinical Profile of Tubotympanic CSOM and Its Management With Special Reference to Site and Size of Tympanic Membrane Perforation, Eustachian Tube Function and Three Flap Tympanoplasty. Indian Journal of Otolaryngology and Head & Neck Surgery. 2012; 64(1):5-12.
5. Dhingra PL. Diseases of ear, nose and throat: 3rd Ed. New Delhi; Elsevier: 2004:87-111.
6. Acuin J, Smith A, Mackenzie I. Treatments for chronic suppurative otitis media. Cochrane Database of Systematic Reviews. 2000, Issue 4.
7. Balen, F., W. Smit, N. Zuithoff, T. Verheij, 2003. Clinical efficacy of three common treatments in acute otitis externa in primary care: randomised controlled trial. BMJ, 327:1201-5.
8. M.Tanya, Kalcioglu, Orphan Outran, RizaDurmaz, ElifAktas. In vitro efficacy of the successive or staggered use of ear drops, Europian Archives of otorhino laryngology and head & neck May 2006;263(5):395-98.
9. Asish J, Amar M, Vinay Hajar e, Sreekantha, Avinash SS and Amareshar M. To study the bacteriological and mycological profile of chronic suppurative otitis media patients and their antibiotic sensitivity pattern. Int J Pharm Bio Sci 2013 Apr; 4(2): (B) 186 -199.
10. V. Rama Chandra Rao, K. Srilatha, S. Visweswara Rao, K. N. Manohar. “Microbiological Study of Ear Discharge and their Antibiotic Sensitivity Pattern in Chronic Suppurative Otitis Media”. Journal of Evolution of Medical and Dental Sciences. October 02, 2014; 3(49): 11698-705.
11. Shamweel Ahmad. Antibiotics in chronic suppurative otitis media: A bacteriologic study. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. November 2013, 14 (3); 191–4.
12. Chhavi Gupta, Anjana Agrawal, Narendra DuttGargav. Role of acetic acid irrigation in medical management of CSOM: A comparative study. Indian Journal of otolaryngology and Head and Neck Surgery, 04 Dec.2014.
13. Eason R, Harding F, Nicholson R, Nicholson D, Pada J, Gathercole J. Chronic suppurative otitis media in the Solomon Islands: a prospective microbiological, audiometric and therapeutic survey. N Z Med J.1986; 99: 812-815.
14. Rhee M-S, Lee S-Y, Dougherty RH, Kang D-H. Antimicrobial Effects of Mustard Flour and Acetic Acid against Escherichia coli O157:H7, Listeria monocytogenes, and Salmonella enterica Serovar Typhimurium. Applied and Environmental Microbiology. 2003; 69(5):2959-2963.
15. Faisal Kany, BDS, PhD, Elham El-Feky, MD and Dia Alnughaimish, BDS, SSC-ARD, The Antimicrobial Effect of Commercial Acetic Acid Against Enterococcus Faecalis, Journal of Applied Sciences Research. 2012; 8(5): 2807-2811.
16. Aminifarshidmehr N.The management of suppurative otitis media with acetic acid solution. Am J. Otol 1996; 17:24-5.
17. McHugh, C., P. Zhang, S. Michalek, P. Eleazer. pH required to kill enterococcus faecalis in vitro. J Endodon. 2004; 30: 218-9.
18. Clayton M, Osborne J, Rutherford D, Rivron R. A double-blind, randomized, prospective trial of a topical antiseptic versus a topical antibiotic in the treatment of otorrhea. Clin Otolaryngol. 1990; 15: 7-10.
How to Cite
Vishwakarma K, Khan FA, Nizamuddin S, Singh P, Yadav L. Role of Topical Acetic Acid in Comparison to Gentamicin for the Management of Chronic Suppurative Otitis Media. Int Arch BioMed Clin Res [Internet]. 2015Sep.3 [cited 2019Oct.17];1(1):13-6. Available from: