Antibiotic prophylaxis in traumatic perforation of the tympanic membrane

Report By: Samuel Guest - StR4
Search checked by Samuel Guest - StR4 In Emergency Medicine
Institution: Blackpool Victoria Hospital
Date Submitted: 18th March 2004
Last Modified: 11th August 2009
Status: Blue (submitted but not checked)

Three Part Question

In patients with [traumatic perforation of the tympanic membrane] are [prophylactic antibiotics] indicated to [reduce the complication rate].

Clinical Scenario

You are on duty in the Emergency Department when you see a 20 year old woman who has perforated her left tympanic membrane with a cotton bud. You wonder if the ENT SHO is right when he suggests prophylactic antibiotics.

Search Strategy

Medline 1966 – 9/2/09. Using the OVID interface
[Tympanic membrane.mp OR Ear drum.mp OR exp.Tympanic membrane perforation]LIMIT to English AND Human
AND [antibiotics.mp OR exp.antibacterial agent]

Search Outcome

244 papers found of which none were relevant

Comment(s)

All studies of perforated TMs routinely used prophylactic antibiotics of some description.

Clinical Bottom Line

There is no evidence comparing prophylactic antibiotics with no treatment and so local guidelines should be followed.