Evidence map›Paper›PMID 42472949›Full record

SynthesisEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Safety and efficacy of ciprofloxacin in the management of pediatric post-tympanostomy tube otorrhea: a systematic review and meta-analysis.

Baraa Awad, Danah Mansour Altewairgi, Shahad Elyas, Alanoud Alaslab, Reema Altwairqi, Atheer Allehyani, Lama Almansouri, Muhnnad Abdulaziz AlGhamdi, Hadi A Al Hakami

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Baraa AwadCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Danah Mansour AltewairgiCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Shahad ElyasCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Alanoud AlaslabCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Reema AltwairqiCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Atheer AllehyaniCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Lama AlmansouriCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Muhnnad Abdulaziz AlGhamdiCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. Muhnnad297@gmail.com.ORCID http://orcid.org/0009-0007-8196-9073
Hadi A Al HakamiCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review and meta-analysis aim to evaluate the efficacy and safety of Ciprofloxacin compared to alternative treatments for managing PTTO.

methodsA comprehensive search was carried out in PubMed, MEDLINE, Springer, and Embase. Randomized controlled trials and interventional studies were included if they assessed Ciprofloxacin in children (0-18 years) with PTTO following tympanostomy tube insertion. The primary outcomes analyzed were clinical resolution of otorrhea, time to resolution, recurrence rates, and adverse effects. For the meta-analysis, only studies comparing Ciprofloxacin to placebo were included to minimize heterogeneity, and outcomes were analyzed using a random effects model with risk ratios and 95% confidence intervals via RevMan 5.4 software.

resultsOut of 704 identified records, four randomized controlled trials met the inclusion criteria, comprising a total of 1,025 pediatric patients aged 6 months to 14 years. These studies evaluated Ciprofloxacin, either as topical drops or sustained-release intratympanic injections, against a placebo for the prevention or treatment of PTTO. All studies reported that Ciprofloxacin significantly reduced the incidence of otorrhea compared to placebo, with relative risk reductions ranging from approximately 46% to 66%. The pooled meta-analysis of 892 participants demonstrated a statistically significant reduction in otorrhea with Ciprofloxacin treatment (risk ratio 0.53; 95% confidence interval 0.35 to 0.79; p = 0.002), with no observed heterogeneity (I² = 0%).

conclusionThis systematic review and meta-analysis demonstrated that ciprofloxacin, whether administered as topical drops or sustained-release formulations, reduces post-tympanostomy tube otorrhea in children without significant safety concerns.

Indexed as

Anti-Bacterial AgentsCiprofloxacinMiddle Ear VentilationOtitis Media with EffusionPostoperative ComplicationsAdministration, TopicalAdolescentChildChild, PreschoolHumansInfantInjection, IntratympanicRandomized Controlled Trials as TopicTreatment OutcomeAnti-Bacterial AgentsCiprofloxacinCiprofloxacinOtorrheaPediatricsTympanostomy

Identifiers

PMID42472949

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.