Comparison between Ciprofloxacin and Amoxycillin /Clavulanic Acid in Treatment of Mild to Moderate Cases of Acute Exacerbation of Chronic Suppurative Otitis Media

Abstract

Chronic Suppurative Otitis Media (CSOM) is a persistent middle ear infection associated with significant morbidity and hearing loss, particularly in low-resource settings. Its management commonly involves the use of topical or systemic antibiotics, among which ciprofloxacin and amoxicillin/clavulanic acid are widely prescribed. This study aimed to compare the clinical efficacy, follow-up behavior, and adverse effect profiles of ciprofloxacin versus amoxicillin/clavulanic acid in the treatment of CSOM. A comparative observational study was conducted on patients diagnosed with CSOM. Participants were assigned to two treatment groups: Group A received ciprofloxacin, and Group B received amoxicillin/clavulanic acid. Ciprofloxacin showed superior clinical efficacy with a higher complete cure rate (33.3%) and no treatment failures, compared to an 18.3% cure rate and 8.3% failure rate in the amoxicillin/clavulanic acid group (P = 0.030). Patients in the ciprofloxacin group also returned for follow-up significantly earlier, indicating faster symptomatic relief. Adverse effects were more frequent and severe in the amoxicillin/clavulanic acid group (P = 0.003); ciprofloxacin was better tolerated overall. At baseline, both groups had comparable symptom severity (p = 0.500). By day 14, ciprofloxacin demonstrated significantly greater clinical improvement, with 76.7% of patients achieving low symptom scores (0–2) compared to 43.3% in the amoxicillin/clavulanic acid group (p = 0.004). Ciprofloxacin demonstrated better clinical effectiveness, faster improvement, and fewer side effects compared to amoxicillin/clavulanic acid, making it a more favorable systemic treatment for CSOM.