Colace and cerumen impaction

29 Feb
BOTTOM LINE (at the top):
–two randomized controlled trials below both comparing Cerumenex and Colace show that Colace is superior to Cerumenex.  And its cheaper!

PMID: 10969225
–Prospective, randomized, controlled, double-blind trial comparing Cerumenex and Colace. 
–50 Patients enrolled, 23 with cerumenex and 27 with colace.

–Groups were similar in age, sex, and proportion of completely obscured tympanic membranes at presentation (78%).
ability to completely visualize the tympanic membrane was significantly greater after treatment with docusate sodium versus triethanolamine polypeptide (81% versus 35%; 95% confidence interval [CI], 22 to 71) particularly in children aged 5 or less (90% versus 0%; 95% CI 50 to 100).

PMID: 11132053
–Immediately after ceruminolytic instillation there was no difference between the 2 treatments.
–However, after 2 irrigations with normal saline, complete clearing was achieved in 82% of the docusate-treated patients and 35% of the triethanolamine-treated patients (95% confidence interval [CI], 22%-71%).
–In other words, every other patient treated with docusate instead of triethanolamine would have benefited (number needed to treat=2.13).
–Although this difference was markedly greater in children younger than 5 years (95% CI, 51%-100%), there were only 4 very young children who received triethanolamine.
–No adverse events were reported.
BOTTOM LINE(again):
colace (docusate sodium) works; helps remove earwax
–it works better than ceruminex (triethanolamine polypeptide)

–no adverse events reported

Submitted by J. Gullo.

Reference(s): article 1, article 2, picture

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