Financial support for this study was provided by the University of Florida. Dr. Antonelli has received financial support from Alcon Laboratories (grant support and honoraria for speaking engagements and advisory board service), Foresight Biotherapeutics (advisory board service), and Otonomy (advisory board service).
Article first published online: 10 SEP 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 11, pages 2529–2532, November 2012
How to Cite
Winterstein, A. G., Castillo, J. M. H., Xu, D., Liu, W. and Antonelli, P. J. (2012), Ototopical neomycin exposure in children with nonintact tympanic membranes. The Laryngoscope, 122: 2529–2532. doi: 10.1002/lary.23554
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 OCT 2012
- Article first published online: 10 SEP 2012
- Manuscript Accepted: 7 JUN 2012
- Manuscript Revised: 30 APR 2012
- Manuscript Received: 12 JAN 2012
- Level of Evidence: 2b
Although contraindicated, neomycin otic preparations may be administered to children with nonintact tympanic membranes (TMs), such as tympanostomy tubes or TM perforations. The goal of this study was to assess the magnitude of neomycin exposure in children with nonintact TMs.
Retrospective drug utilization study.
Medicaid claims data (years 1999–2006) from 28 states for children aged 0 to 18 years were analyzed to identify new cases of tube placement or TM perforation. Cases were followed for 12 months to determine neomycin otic utilization.
Of the 300,470 children with nonintact TMs, neomycin otic preparations were prescribed in 43,815 (15%). Nontoxic agents (ofloxacin or ciprofloxacin) were used in 48%. In 19%, neomycin preparations were prescribed at the day of initial nonintact TM diagnosis, 52% and 71% within the first 3 or 6 months, respectively. Neomycin otic utilization decreased from 27% in cases diagnosed in 1999 to 7% in 2005 (P < .0001).
Many children with nonintact TMs receive exposure to agents with potential ototoxicity, despite the availability of safer alternatives. Further study is necessary to determine why neomycin otic preparations continue to be prescribed in the presence of nonintact TMs and if such exposure is associated with ototoxicity. Laryngoscope, 2012