Colace and cerumen impaction

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