Biomedical subjects

Pa-Chun Wang

Publications and source records attributed to Pa-Chun Wang.

At least 19 recordsLinked to original sources

PubMed2006

Impact of severe acute respiratory syndrome care on the general health status of healthcare workers in taiwan.

BACKGROUND: The impact of the outbreak of severe acute respiratory syndrome (SARS) was enormous, but few studies have focused on the infectious and general health status of healthcare workers (HCWs) who treated patients with SARS. DESIGN: We prospectively evaluated the general health status of HCWs during the SARS epidemic. The Medical Outcome Study Short-Form 36 Survey was given to all HCWs immediately after caring for patients with SARS and 4 weeks after self-quarantine and off-duty shifts. Tests for detection of SARS coronavirus antibody were performed for HCWs at these 2 time points and for control subjects during the SARS epidemic. SETTING: Tertiary care referral center in Taipei, Taiwan. SUBJECTS: Ninety SARS-care task force members (SARS HCWs) and 82 control subjects. RESULTS: All serum specimens tested negative for SARS antibody. Survey scores for SARS HCWs immediately after care were significantly lower than those for the control group (P<.05 by the t test) in 6 categories. Vitality, social functioning, and mental health immediately after care and vitality and mental health after self-quarantine and off-duty shifts were among the worst subscales. The social functioning, role emotional, and role physical subscales significantly improved after self-quarantine and off-duty shifts (P<.05, by paired t test). The length of contact time (mean number of contact-hours per day) with patients with SARS was associated with some subscales (role emotional, role physical, and mental health) to a mild extent. The total number of contact-hours with symptomatic patients with SARS was a borderline predictor (adjusted R2=0.069; P=.038) of mental health score. CONCLUSIONS: The impact of the SARS outbreak on SARS HCWs was significant in many dimensions of general health. The vitality and mental health status of SARS HCWs 1 month after self-quarantine and off-duty shifts remained inferior to those of the control group.

Adult↗

PubMed2006

Taste disturbance after uvulopalatopharyngoplasty for obstructive sleep apnea.

OBJECTIVES: This study investigated factors that may attribute to taste disturbance (TD) following uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA). STUDY DESIGN: This longitudinal intervention study enrolled 108 patients who received UPPP for OSA. Patients who reported TD in the postoperative questionnaire were examined using the three-drop-method gustatory function test (GFT). RESULTS: The GFT revealed that 5 patients (4.6%) reporting TD lost at least one of the four basic tastes 3 months after surgery. Deficiency of sweet sense was the most common type of TD (80%). The use of electrocautery for developing the uvulopalatal flap was the only significant predictor that may attribute to TD (odds ratio: 14.1). Repeating the GFT 9 months after operation showed a restoration of tastes in 4 patients. CONCLUSIONS: Development of the uvulopalatal flap using electrocautery may increase the likelihood of postoperative TD. Patients with taste disturbance after UPPP may eventually recover their taste function over time. EBM RATING: C-4.

Adolescent↗

PubMed2006

Generic and specific quality-of-life measures in Taiwanese adults with sleep-disordered breathing.

OBJECTIVE: To investigate the quality-of-life status of Taiwanese adult patients with sleep-disordered breathing (SDB). STUDY DESIGN AND SETTING: A prospective, quality-of-life survey in a tertiary referral sleep center on 94 consecutive adult SDB patients. Patients were evaluated with polysomnogram, Medical Outcome Study SF-36 Health Survey, Snore Outcome Survey (SOS), and Epworth Sleepiness Scale (ESS). RESULTS: SDB patients have significantly lower scores in all 8 SF-36 subscales (P < 0.05) than do normative Taiwan adult population. Apnea patients have lower SOS (34.5 +/- 7.5 vs 40.1 +/- 10.3, P = 0.005) and higher ESS scores than do simple snorers (8.8 +/- 5.1 vs 11.7 +/- 5.2, P = 0.03). Patients with a higher degree of sleepiness show worse performance in all dimensions of their general health status (P values 0.0005 to 0.01). Deep sleep (stage 3 + 4) is predictive of SF-36 role: physical (beta = 1.63, P = 0.04), bodily pain (beta = 1.22, P = 0.01), vitality (beta = 1.05, P = 0.01), subscales scores (adjusted R(2) 0.005 to 0.1). CONCLUSION: SDB has considerable impact on a patient's global health status. SIGNIFICANCE: Daytime sleepiness, rather than apnea, is a major quality-of-life determinant. EBM RATING: B-2b.

Activities of Daily Living↗

PubMed2005

Is guidewire exchange a better approach for subclavian vein re-catheterization for chronic hemodialysis patients?

BACKGROUND: The objectives of this study were to compare outcomes and survival rates of subclavian vein re-catheterization through guide wire exchange (GWE) or de novo insertion (DN). MATERIALS AND METHODS: The study was conducted in a retrospective manner. Medical records of 36 patients who received percutaneous subclavian vein re-catheterization for hemodialysis in our institution during the period from April 1, 2001 to September 30, 2004 were reviewed. All patients had at least 2 catheter insertions records in our institute. Incidences of adverse events (infection, thrombosis) were compared between GWE and DN groups using x2 test. Predictors for adverse event occurrences were analyzed using logistic regression models. Cox proportional hazard model was used to investigate the predictors for adverse event-free catheter days. Kaplan-Meire survival curves were computed and compared using log rank test. RESULTS: Information were generated from 98 catheters (41 from DN, 57 from GWE groups). The average catheter usage was 2.8+/-0.9 devices per patient and the mean catheter-indwelling-day was 125.4+/-129.5 days in this cohort. We found GWE group had significantly lower thrombosis rate (49.1% vs. 85.4% for DN group, P<0.000) in general. Surgical approach was a significant risk factors for catheter thrombosis (GWE vs. DN, odds ratio=0.261, P=0.05). The actuarial survival rates for GWE were > or =30 days, 85.4%; > or =60 days, 75.5%; > or =90 days, 64.5%; > or =180 days, 44.3%. The actuarial survival rates for DN were > or =30 days, 70.7%; > or =60 days, 58.5%; > or =90 days, 34.2%; > or =180 days, 18.4%. GWE group catheters had significantly higher catheter survival rates (P=0.0009). Mahukar catheter (hazard ratio 0.514, P=0.03), non-shock (hazard ratio 3.358, P=0.04), and older age (hazard ratio 0.958, P=0.026) were predictors of adverse event-free remaining catheter days. CONCLUSION: We suggest that GWE might be a favorable option over DN insertion when revised subclavian vein catheterization is inevitable. GWE can be performed repeatedly without compromising catheter outcomes.

Adult↗

PubMed2005

Comparisons of outcomes and survivals for two central venous access port systems.

BACKGROUND: This study compares the outcomes and survivals between two central venous access port systems. STUDY DESIGN: Medical records from 298 cancer patients who had received open-end (Deltec, N = 159) or closed-end (Groshong, N = 139) port catheter insertions were retrospectively reviewed. METHODS: The infection, thrombosis, and surgical complication rates (chi-square test), as well as mean catheter-indwelling-days (t-test) were compared. Kaplan Meier analysis and stratified log rank test were used to compare actuarial survival rates. Cox proportion hazard model was applied to analyze the outcomes predictors. RESULTS: The total catheter-indwelling-day was 116,603 days in general for this cohort. The Groshong catheters (569 +/- 386.1 days) had longer (P < 0.001) mean catheter-indwelling-day than did Deltec catheters (239 +/- 235.6 days). But the per 1,000 catheter day infection (Deltec 0.18, Groshong 0.16), thrombosis (Deltec 0.07, Groshong 0.06), and surgical complication rates (Deltec 0.07, Groshong 0.02) were equivalent (P > 0.05) between two groups. Patients with leukemia were at higher risk (odds ratio 13.4, P = 0.009) to develop adverse events. However, two types of catheters had similar actuarial survival rates at end of follow up (P > 0.05). CONCLUSION: We found infection, thrombosis occlusion, surgical complication, and actuarial device survival rates were similar between Deltec and Groshong groups. Hematogenous malignancy was a risk factor for catheter failure.

Catheterization, Central Venous↗

PubMed2005

Nasal resistance in patients with obstructive sleep apnea.

The aim of this study was to investigate the relationship between the severity of obstructive sleep apnea (OSA) and nasal resistance (NR). Eighty-five consecutive patients were recruited owing to their symptoms indicating OSA. All patients received polysomnography and anterior rhinomanometry (performed during wakefulness in the supine position). Patients were divided into low and high NR groups according to their rhinomanometric results; their polysomnographic, anthropometric and demographic data were compared. Correlation and regression analyses were conducted to investigate the associations between polysomnography and rhinomanometric measurements. The two studied groups were not different in body mass index, sex and age (p > 0.05), but the high NR group showed a significantly higher snoring index (p = 0.03). Furthermore, unilateral higher NR correlated significantly with respiratory disturbance index (r = 0.30, p = 0.006) and minimal oxygen saturation (r = -0.22, p = 0.04); total NR also correlated with the snoring index (r = 0.23, p = 0.04). Stepwise multivariate regression models revealed that unilateral higher NR was predictive of respiratory disturbance index (R(2) = 0.087, p = 0.006). The research implied that NR is a possible contributing factor to snoring, with a need for further investigation to confirm the correlation between unilateral higher NR and the severity of OSA.

Adolescent↗

PubMed2005

A case of tympanogenic labyrinthitis complicated by acute otitis media.

Widespread use of antimicrobial drugs in the management of otitis media has significantly reduced the incidence of labyrinthitis nowadays. Cases of tympanogenic labyrinthitis following acute otitis media have rarely been reported in recent literature on otolaryngology. We report an unusual case of tympanogenic labyrinthitis that presented with sudden sensorineural hearing loss (SNHL) following acute otitis media in an adult who had no previous otological complaints. An audiogram revealed SNHL with pure tone threshold of 43.7 dB in the left ear. MRI was helpful to identify the inflammatory change of the membranous labyrinth. The patient's hearing returned to normal after treatment. The definite diagnosis of serous labyrinthitis was established retrospectively.

Acute Disease↗

PubMed2005

Adult acute epiglottitis: experiences in a Taiwanese setting.

OBJECTIVE: Acute epiglottitis is a potentially disastrous disease seen occasionally in otolaryngology emergency service. This study reports our experiences in managing adult patients with acute epiglottitis in a Taiwanese setting. STUDY DESIGN: Admission medical records from 46 adult patients with acute epiglottitis over a period of 8 years in a tertiary referral otolaryngology service were retrospectively reviewed. RESULTS: No mortality was reported; 4 (8.7%) patients were supported by artificial airway. A total of 16 (34.8%) patients had comorbid conditions; hypertension and diabetes mellitus were the most common systemic diseases. Patients who needed artificial airway support tended to have more systemic comorbidities ( P = 0.001) and a higher level of hyperglycemia ( P = 0.004) than those who did not need airway support. The incidences of drooling, stridor/dyspnea, and muffled voice were significantly higher in the airway-supported group ( P < 0.05). Stridor/dyspnea is a reliable clinical predictor of airway compromise (odds ratio 2.94; P = 0.0277). CONCLUSION: Dyspnea is a warning sign of impending airway collapse during an episode of acute epiglottitis. Adult patients with more systemic comorbidities might bear higher risk of airway compromise; the role of diabetes mellitus can't be overlooked.

Acute Disease↗

PubMed2005

Cost-utility analysis of tympanomastoidectomy for adults with chronic suppurative otitis media.

OBJECTIVE: To undertake cost-utility analysis for tympanomastoid surgery to analyze its cost-effectiveness in treating adult chronic suppurative otitis media (CSOM). METHODS: Seventy-seven patients with CSOM were evaluated with the Chronic Ear Survey (CES) before and 1 year after tympanomastoid surgery. Direct health care cost data during the 1st year after operation were retrieved. The utility gain was defined as change in the CES total score. The cost-utility ratio (CUR) was defined as cost per utility gain. Patients were stratified by disease type into wet-ear and dry-ear groups. RESULTS: The average total direct cost attributable to tympanomastoid surgery is (in New Taiwan dollars) 45,716.3 in the 1st postoperative year, and the average CUR is 1850.9 New Taiwan dollars. The lower CUR of 1280.9 New Taiwan dollars for the wet-ear group is due to the greater utility gain (37.6 +/- 3.4 versus 24.4 +/- 6.8, P < 0.05) despite its higher cost (48,163.2 New Taiwan dollars versus 38,419.7 New Taiwan dollars, P < 0.05). CONCLUSIONS: Treating continuously or intermittently draining ears is more cost-effective, as compared with managing a quiescent infection, because of its favorable utility gain.

Adult↗

PubMed2005

Combined nasal-palatopharyngeal surgery for obstructive sleep apnea: simultaneous or staged?

CONCLUSIONS: Our data indicate that surgical outcomes in a simultaneous surgery group were equivalent to those in a staged surgery group. The simultaneous type of surgery was more cost-effective in terms of total hospitalization expenses. OBJECTIVE: To compare the outcomes of two types of combined nasal-palatopharyngeal surgery (simultaneous and staged) for the treatment of obstructive sleep apnea (OSA). MATERIAL AND METHODS: A total of 85 consecutive patients were enrolled in the study. All patients had OSA and its associated symptoms, were type I according to the Fujita classification, stage 1 or 2 according to the Friedman classification and had nasal obstruction with nasal septal deviation. A modified form of uvulopalatopharyngoplasty (extended uvulopalatal flap surgery) and septomeatoplasty were used to correct upper airway abnormalities. Patients chose to have either a simultaneous (n = 55) or staged (n = 30) type of operation. All patients underwent overnight polysomnography at baseline and < or = 6 months after completion of the operations. Surgical results (reduction of OSA), patient satisfaction, complications and hospitalization expenses were compared between the two groups. RESULTS: The two groups comprised body mass index- and respiratory disturbance index (RDI)-matched cohorts (p > 0.05). Postoperative decreases in RDI were significant in both groups (p < 0.001), and postoperative RDI was indistinguishable between the two groups (p = 0.77). Incidences of surgical complications, including tonsillar bleeding, nasal septal hematoma, nasal regurgitation and the sensation of a lump in the throat, were similar in the two groups (p = 0.35). The simultaneous surgery group incurred lower total hospitalization expenses than the staged surgery group (p < 0.001).

Adult↗

PubMed2004

Changes of sleep-disordered breathing after laryngeal surgery in patients with bilateral vocal fold paralysis.

Snoring is the most obvious symptom of sleep-disordered breathing (SDB). Vibratory sound usually originates from the pharynx; however, in some circumstances, the narrowing of glottic structures can also cause nighttime breathing noise. This clinical study investigated the role of laryngeal obstruction in patients with SDB. Nine female patients with paralysis of bilateral vocal folds were enrolled in this study. All the patients received unilateral laser arytenoidectomy as the only treatment. Nocturnal polysomnography (PSG) was performed at baseline and 6 months after the operation. Parameters of PSG including the respiratory disturbance index (RDI) and snoring index (SI) were recorded, as well as the subjective Epworth Sleepiness Scale (ESS). Before surgery, six patients (66.6%) were identified as having obstructive sleep apnea (OSA, RDI>5). After the operation, the SI improved significantly (P=0.02). The RDI (P=0.07) and ESS (P=0.11) showed no significant improvement. The success rate of surgery in OSA patients was 66% (4/6) according to the criteria of a greater than 50% reduction of the preoperative RDI and less than 20 events per hour. The mechanism, outcomes and causes of failure are discussed in this unusual larynx-related SDB.

Adult↗

PubMed2004

Changes in quality of life and respiratory disturbance after extended uvulopalatal flap surgery in patients with obstructive sleep apnea.

OBJECTIVE: To evaluate the subjective and objective outcomes of extended uvulopalatal flap (EUPF) surgery in patients with obstructive sleep apnea. DESIGN: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Snore Outcomes Survey (SOS), Epworth Sleepiness Scale (ESS), and polysomnography were performed preoperatively and then 6 months postoperatively. SETTING: Tertiary care, sleep disorders referral center. PATIENTS: Fifty-five consecutive patients (52 men and 3 women; mean age, 45 years) with obstructive sleep apnea. INTERVENTION: EUPF surgery. MAIN OUTCOME MEASURES: Overnight polysomnography variables included respiratory distress index (RDI), snore index, minimum oxygen saturation, sleep stages 1 and 2, sleep stages 3 and 4, rapid eye movement, and sleep efficiency. Questionnaire variables included SF-36, SOS, and ESS scores. Success of the operation was defined as a more than 50% reduction of the RDI from the initial value and a postoperative RDI of less than 20. RESULTS: The overall success rate of the EUPF surgery was 82%; the RDI, snore index, and minimum oxygen saturation improved significantly after surgery (P<.001). Sleep architecture in overnight polysomnography remained unchanged (P=.48 and P=.74). Patients demonstrated significant improvement in both their SOS and ESS scores (P<.001) and significant increases in 7 of 8 SF-36 subscales (P<.05 for all). However, there was poor correlation between the improvement in quality of life and the reduction in sleep-related respiratory events. CONCLUSIONS: Extended uvulopalatal flap surgery can greatly reduce sleep-related adverse events and proves to be an effective therapy to enhance the quality of life of patients with obstructive sleep apnea. This study also suggests that subjective and objective outcomes are equally important when reporting the results of EUPF surgery.

Adult↗

PubMed2004

Cost-utility analysis for endoscopic sinus surgery.

OBJECTIVE: To undertake cost-utility analysis for endoscopic sinus surgery (ESS) in order to analyze the cost-effectiveness of different chronic sinusitis severity groups. METHODS: One hundred ninety-two patients with chronic sinusitis were evaluated with a Chronic Sinusitis Survey (CSS) before and 1-year after ESS. Direct health care cost data during the first year after operation were retrieved. The utility gain is defined as change in the CSS total score. The cost-utility ratio was defined as cost per utility gain. Patients are stratified by disease severity using the Harvard Staging System. RESULTS: The average total direct cost attributable to ESS is 40,829 NT dollars in the first postoperative year and the average cost-utility ratio is 2194.42 NT dollars. The high cost-utility ratio of 3246.45 NT dollars for pansinusitis cases is due to the higher cost and limited utility gain. CONCLUSIONS: Treating mild and moderate chronic sinusitis are most cost-effective because of their favorable utility gain and relatively reasonable cost. However, there is no proportional linear relationship between disease severity and cost-utility ratio.

Adolescent↗

PubMed2004

Same-stage palatopharyngeal and hypopharyngeal surgery for severe obstructive sleep apnea.

OBJECTIVES: To investigate surgical outcomes with two types of combined palatopharyngeal and hypopharyngeal surgery for the treatment of severe obstructive sleep apnea (OSA). MATERIAL AND METHODS: Twelve consecutive OSA patients with a respiratory disturbance index (RDI) >30/h and Fujita type II anatomy were enrolled. Patients were divided into two groups according to their fiberscopic manifestations. Six patients with obstruction at the uvulopalatal complex and tongue base (Group 1) were selected for extended uvulopalatal flap (EUPF) and midline laser glossectomy (MLG). EUPF and laser lingual tonsillectomy were performed in another six patients shown to have obstruction at the uvulopalatal complex and lingual tonsil (Group 2). Polysomnographic parameters included the RDI and minimal oxygen saturation (MSAT). Surgical success was defined as a postoperative RDI of <20/h and a >50% reduction in the preoperative RDI. RESULTS: Six months postoperatively, 5 patients (83.3%) had responded successfully in Group 1 and none in Group 2. In Group 1 the mean RDI decreased from 50.7+/-12.6 to 8+/-14.3 (95% CI 23.0-62.7; p<0.01) and MSAT increased from 76.3%+/-11.6% to 88.8%+/-3.2% (95% CI -25.9-0.87; p=0.06). There was no improvement in sleep parameters in Group 2 patients. No persistent nasal regurgitation, swallowing disturbance or change in taste was noted at 1-year follow-up in either group. CONCLUSIONS: EUPF combined with MLG improves OSA in Fujita type II patients. The hypertrophic lingual tonsil, although obscure the laryngeal structure, did not contribute significantly to OSA.

Adult↗

PubMed2004

Endoscopic potassium-titanyl-phosphate laser treatment for the reduction of hypertrophic inferior nasal turbinate.

OBJECTIVE: This study investigated the efficacy of using the KTP/532 laser in endoscopic inferior turbinate reduction surgery. BACKGROUND DATA: Potasium-titanyl-phosphate (KTP/532) laser is a useful tool in endoscopic intranasal operations, due to its outstanding capabilities in hemostasis, tissue penetration, and the maneuverability of its flexible transmission optic fiber. MATERIALS AND METHODS: A total of 124 patients (male/female 73:51, mean age 38.7 +/- 12.3 years) with chronic hypertrophic rhinitis who received endoscopic KTP/532 laser inferior turbinate reduction surgery (7 Watts, continuous mode, 0.6-1-mm spots) were available for follow-up (mean follow-up period, 25.1 +/- 7.3 months). Medical records were retrospectively reviewed, and patients were interviewed with a questionnaire. RESULTS: The KTP/532 laser was excellent in relieving nose obstruction caused by inferior turbinate hypertrophy; 87% of patients reported improvement. The outcomes were less promising in reducing post-nasal drip; 12.9% reported only some improvement. Under intranasal endoscopy, the risk of postoperative bleeding and complication was low. CONCLUSION: The findings proved that, with the use of an endoscope, the KTP/532 laser appears to be an excellent alternative for treating hypertrophic inferior turbinate.

Adult↗

PubMed2004

Mood improvement after surgery for obstructive sleep apnea.

OBJECTIVE: Patients with obstructive sleep apnea (OSA) may experience unfavorable psychologic symptoms such as depression and anxiety. The aim of this study was to confirm this hypothesis and to investigate whether the psychologic symptoms among OSA patients can be relieved by surgical intervention. STUDY DESIGN: Prospective, longitudinal intervention study. METHODS: The 5-Item Mental Health scale (MH-5) was used to evaluate the postoperative changes of mood after extended uvulopalatal flap (EUPF) surgery on 84 Taiwanese patients with OSA. The preoperative and postoperative MH-5 data obtained from these patients were compared with a Taiwanese population norm. RESULTS: Before surgery, the MH-5 scores of the OSA patients were significantly worse than the Taiwanese population norm of 72.8 (P <.0001). Postoperatively, mean MH-5 scores significantly increased from 61.8 +/- 16.0 to 70.0 +/- 15.8 (P =.0006). The effect size of this score change was 0.51, indicating a moderate degree of mood improvement. However, this score was still inferior to that of the population norm (P =.0045). The mood improvement was not significantly associated with the changes in either sleep apnea events or the level of sleepiness. Neither the changes in respiratory disturbance index (P =.4382), maximum arterial oxygen saturation (P =.4866), nor the change in Epworth Sleepiness Scale scores (P =.4951) were predictive of the MH-5 score improvement (R = 0.07). CONCLUSIONS: This study demonstrated that patients with OSA had a higher level of anxiety, depression, and probable behavior or personality changes than the population norm. EUPF surgery could significantly improve the mood status among OSA patients; the effect of surgery was mild but clinically relevant. However, the extent of mood improvement experienced by OSA patients receiving operations may not simply be attributable to the changes in sleep apnea events or a reduced level of sleepiness.

Adult↗

PubMed2004

Use of morphological indicators to predict outcomes of palatopharyngeal surgery in patients with obstructive sleep apnea.

There is no consensus on how to quantify the abnormality of upper airway structures in patients with obstructive sleep apnea (OSA). This research aimed to use morphological indicators as clinical predictors to correlate morphological stage and surgical results in OSA patients. One hundred and five patients with OSA received palatopharyngeal surgery, i.e. extended uvulopalatal flap (EUPF). Morphological indicators including modified Mallampati grade (MMP), tonsil size, and body mass index were used to stage OSA patients preoperatively. Change of respiratory disturbance index (RDI) was used to monitor change of sleep apnea events. Success rates were compared among patients of different morphological stages. One year after EUPF, the success rates of EUPF in stage I, II, and III patients were 100, 92.9 and 61.4%, respectively. Change of RDI was significantly correlated with MMP and tonsil size. MMP and tonsil size were predictive of the change of RDI (R(2) = 0.29). Morphological stage may serve as a reliable selection criterion for patients undergoing EUPF surgery and can significantly predict the change of sleep apnea events following EUPF surgery.

Adult↗

PubMed2004

Topical vancomycin for chronic suppurative otitis media with methicillin-resistant Staphylococcus aureus otorrhoea.

There has been a steady increase in the number of cases of methicillin-resistant Staphylococcus aureus (MRSA) otorrhoea; this is a growing concern. The purpose of this study was to evaluate the efficacy of topical vancomycin treatment in patients with MRSA otorrhoea. Fifty-five patients with MRSA otorrhoea were prospectively enrolled into the study. Thirty-five patients were treated with vancomycin eardrops as outpatients. The concentration of the locally prepared vancomycin solution was 25 mg/ml. The dose of vancomycin was two drops three times daily for 10 days. As a control group, 20 patients were treated with gentamicin 0.3% solution. Data were analysed by the Mann-Whitney U test to compare the efficacy of vancomycin eardrops and gentamicin eardrops. In the vancomycin group, the otorrhoea was significantly reduced in 33 ears (94%); in the gentamicin group, in four ears (20 per cent); this reduction was statistically significant (P < 0.03). The use of topical vancomycin treatment was effective for patients with MRSA otorrhoea refractory to conventional antibiotic treatment.

Administration, Topical↗