Ciprofloxacin in the treatment of chronic suppurative otitis media

To the Editor: Although I am retired, I wish to make some comment on the controversy about the use of ciprofloxacin in the treatment of chronic suppurative otitis media.1 I still feel uneasy when there is mention of the topical use of an antibiotic that may be used either orally or parenterally.

Many years ago, when I had a large practice, including paediatric patients, chronic suppurative otitis media was common, although most cases responded to the classical ear drops. However, some persisted and, not infrequently, a new patient would present with this problem. As mentioned, most were the result of a pseudomonas infection.

Pseudomonas was then a common problem in chronic leg ulcer of the elderly, and I had found that treatment with Burrow’s solution (aluminium sulfate [2.25 g], acetic acid [33%], tartaric acid [0.45 g], calcium carbonate [1 g], purified water [7.5 mL]) was very successful and continued to be successful right up to my retirement, even in new cases which had been treated unsuccessfully with ciprofloxacin.

Before the advent of ciprofloxacin, I used Burrow’s solution ear drops in many adult cases of chronic suppurative otitis media with great success. As the number of children with this problem grew, I attempted to get advice on the use and any toxicity of Burrow’s solution ear drops in children. I could not find anyone at the Children’s Hospital with any experience, but the consensus was that it was unlikely to be toxic.

Although at first I had difficulty in getting the chemist to make up ear drops for adults, by this time there was little problem getting them made for children, and the results were dramatic. There were recurrences, but these responded as well as they did the first time they were treated. Advice on correct aural hygiene after swimming and bathing was important. Burrow’s solution kills pseudomonas.

Am I too old fashioned?