Korean J Fam Med 2018; 39(1): 2-9  https://doi.org/10.4082/kjfm.2018.39.1.2
Efficacy of Boric Acid as a Treatment of Choice for Chronic Suppurative Otitis Media and Its Ototoxicity
Indri Adriztina1,*, Linda Irwani Adenin2, Yuliani Mardiati Lubis2
1Department of Otorhinolaryngology, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
2Department of Otorhinolaryngology, H. Adam Malik General Hospital, Medan, North Sumatera, Indonesia
Indri Adriztina https://orcid.org/0000-0003-0651-9594
Tel: +62-61-8211633, Fax: +62-61-8219411, E-mail: adriztina@yahoo.com
Received: July 6, 2017; Revised: August 5, 2017; Accepted: August 29, 2017; Published online: January 20, 2018.
© Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Chronic suppurative otitis media (CSOM) is one of the most common chronic infectious diseases worldwide, especially affecting children. The patients or the parents of the affected children are often worried about the cost of medical visits, prescription medicines, or inconsistently effective medication. The complications of CSOM have been greatly reduced because of the development of antibiotics; however, the irrational use of antibiotics has led to the emergence of organisms resistant to the commonly used drugs. Owing to the increase in antibiotic resistance, the development of new treatments that will efficiently eradicate infectious microorganisms has become imperative. Boric acid solutions are effective in the treatment of CSOM because of their acidic effect. Various databases, such as the PubMed, The Cochrane Library, and SciELO, were searched for references related to the efficacy of boric acid in the treatment of mucosal CSOM, as well as its ototoxicity. The search revealed that boric acid is relatively effective in treating CSOM, especially at a high concentration. Boric acid in distilled water was found safe in animal studies. However, the ototoxicity of boric acid concentrations higher than 4% needs further evaluation, considering the effectivity of boric acid at high concentrations.
Keywords: Boric Acids; Suppurative Otitis Media; Biofilms; Toxicity


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