With a perforation or exposed mastoid cavity, would you consider taking a
swab and/or using systemic antibiotics?
Mary Hawking
"thinking - independent thinking - is to humans as swimming is to cats: we
can do it if we really have to." Mark Earles on Radio 4.
and don't forget patients like Fred!
http://primaryhealthinfo.wordpress.com/2011/12/11/fred-and-his-dog-an-update
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-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Julian Bradley
Sent: 07 February 2012 11:43
To: [log in to unmask]
Subject: Re: Gentamicin ear drops and ototoxicity
1) Confession of general ignorance - I'm coming to this topic
not because I know a lot but because I know nothing above basic GP stuff
2) See websites listed
It is clear however that there is good evidence of animal toxicity,
there is anecdotal evidence of human toxicity, and it is
inconceivable that a prospective study would ever get ethical approval.
The answer to your question is therefore that I don't think there
will, in the foreseeable future, be a proper answer to your question.
UK GPs are therefore stuck.
If I understand correctly:
Use of gentamicin will be off licence / label, because in the UK use
with perforations is excluded.
Alternatives such as properly licensed Cipro ear drops don't seem to
be available.
My answer (theoretical, as I can't remember the last time this came
up) has been to use Gentamicin short term (1 week or less).
However even as a locum in a teaching / training practice good
questions do come up...
and I did think this was a topic worth a debate.
J
At 11:18 07/02/2012, you wrote:
>Is there evidence that typical prep even with perf causes ototoxicity?
>
>As in what good quality prospective trial in a primary care setting using
>similar product to gentisone hc (if that's the commonly used uk prep?) For
>usual durations (say up to 2-3 weeks at the outside) have you identified?
>
>I've never tracked down a good ref so would be interested if you have one
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