S.R. Agrawal, M.D., D.L.O.,
Officiating Head,

and
A.K. Saxena, M.B.,B.S., D.L.O.,
Post-graduate Student, E.N.T. Department, G.R. Medical College, Gwalior, (M.P.).

Septilin is a drug which is chemically distinct from other available antibiotics.

Each tablet of Septilin contains:

It is claimed that Septilin is very effective in chronic infections especially of the upper respiratory tract and ear.

The present study with Septilin was done in patients with chronic suppurative otitis media. The culture and sensitivity (to commonly used chemotherapeutic agents) of causative organisms was done in one group of patients.

Patients with suppurative otitis media were selected from the Out-Patient Department and E.N.T. Ward of J.A. Group of Hospitals attached to G.R. Medical College, Gwalior. A total of 150 patients of different age groups suffering from chronic suppurative otitis media were selected. In all cases, a complete E.N.T. examination was done.

Group A consisted of 75 patients whose ear swabs were taken and culture and sensitivity test were done in cases. Other investigations done were: total and differential W.B.C. count, urine examination, X-ray of both mastoids, X-ray of paranasal sinuses, surgical interventions such as antrum puncture and lavage.

Group B comprised of 75 patients who were taken up for treatment without the usual investigation.

Tonsillectomy was done in some cases. The cases were categorised as mild or severe grade infections. The dose of Septilin employed depended on the severity of the infection, response to the drug during the first two weeks and on the age of the patients. The dosage schedule is given in Table I.

In severe cases in adults dose of 2 t.i.d. was continued for 3-4 weeks. In mild cases dose of 1 t.i.d. was continued for 3-4 weeks.

The response to Septilin was evaluated as excellent, good, poor and no response. Clinical improvement was judged on the basis of the degree of discharge, whether it was reduced, stopped or became thin and then reduced.

Before starting Septilin therapy, culture and sensitivity of ear swab were done in 75 patients. The organisms cultured and their sensitivity to various chemotherapeutic agents has been shown in Table II.

The clinical response to therapy in both the groups of patients (Group A— where culture and sensitivity of ear swab was done and Group B — where therapy was started without such investigation) has been shown in Tables III and IV.

The average duration of therapy was 4 weeks and the average duration of follow-up was 6 weeks.

The present study shows that Septilin therapy was effective in cases of chronic suppurative otitis media, observations being made on the basis of response to therapy.

Out of the 75 patients of Group A (cases resistant to all antibiotics):—

Out of 75% patients of Group B—where culture and sensitivity was not done, the results were as follows :

53% excellent, 21.33% good response, 14.66% poor response, 12% no response. No drug reaction or any sign of toxicity was noticed.

Vishwakarma, S.K, also observed in his trial that Septilin is equally effective in acute and chronic infections of ear, nose and throat with minimal recurrence. The marked anti-inflammatory and anti-exudative property of Balsamodendron mukul has been demonstrated by Gujral, M.L. (1962) in experimental rate. This is in accord with the result of the present trial.

Septilin therapy was found to be effective in cases of chronic suppurative otitis media with minimal recurrence (only 2 in Group A and 5 in Group B) particularly in resistant cases. As far as recurrence is concerned, this was overcome when therapy was continued again for about 4-5 weeks without any sign of toxicity, sensitivity of hypersensitivity.

The cause of recurrence was probably due to the discontinuation of the drug by the patients. Secondly it may be due to the fact that patients did not follow the instructions of aural hygiene properly.

The authors are thankful to Dr. J.N. Monga, M.D., Professor and Head of the Department of Pathology, G.R. Medical College, Gwalior, for the necessary guidance and facilities. We are also thankful to Dr. S. Vashishtha, M.S., Superintendent and Joint Director, J.A. Group of Hospitals, Gwalior for permitting us to conduct the trial.

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