Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media

Recurrent acute otitis media (AOM) is an extremely prevalent disease in young children. Epidemiologic associations suggest that primary prevention or reduction of AOM frequency may be achieved with breast-feeding during infancy, elimination of household tobacco smoking, and use of small rather than large day-care arrangements for infants and toddlers. Secondary antimicrobial prophylaxis with amoxicillin or sulfisoxazole reduces the frequency of recurrent AOM by about 50%, but it does not appear to reduce the duration of otitis media with effusion (OME). Tympanostomy tube insertion is not as effective as amoxicillin in reducing AOM frequency in children without OME. Adenoidectomy appears to be warranted for children who develop recurrent AOM after extrusion of tubes. Vaccines against the common bacteria and viruses causing AOM hold the greatest promise of preventing AOM and blocking the sequence of pathologic events leading to chronic OME and middle ear sequelae. The greatest progress has been made recently with pneumococcal protein conjugate vaccines, and clinical testing is in progress.

Download Full-text

Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media: Results of a randomized clinical trial

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/0165-5876(92)90040-v ◽

1992 ◽

Vol 24 (3) ◽

pp. 286

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Otitis Media ◽

Antimicrobial Prophylaxis ◽

Acute Otitis Media ◽

Tympanostomy Tube ◽

Tube Insertion ◽

Recurrent Acute Otitis Media

Download Full-text

One-Year Follow-Up after Tympanostomy Tube Insertion for Recurrent Acute Otitis media

ORL ◽

10.1159/000276428 ◽

1993 ◽

Vol 55 (4) ◽

pp. 226-229 ◽

Cited By ~ 4

Author(s):

F. Debruyne ◽

M. Degroote

Keyword(s):

Otitis Media ◽

Acute Otitis Media ◽

Tympanostomy Tube ◽

Tube Insertion ◽

Recurrent Acute Otitis Media ◽

One Year

Download Full-text

Antimicrobial Prophylaxis for Recurrent Acute Otitis Media

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894810903s213 ◽

1981 ◽

Vol 90 (3_suppl2) ◽

pp. 53-57 ◽

Cited By ~ 6

Author(s):

Jack L. Paradise

Keyword(s):

Otitis Media ◽

Antimicrobial Prophylaxis ◽

Acute Otitis Media ◽

Management Option ◽

Recurrent Acute Otitis Media

Antimicrobial prophylaxis for children who have frequently recurring, severe episodes of acute otitis media appears to constitute a reasonable management option, even though it is not yet clear whether the advantages outweigh the disadvantages and risks. It remains for well-designed and well-executed studies that extend over relatively long periods to indicate whether this approach to management is the best of the available options, and if so, which of the available drugs is preferable.

Download Full-text

Management of recurrent acute otitis media in children: systematic review of the effect of different interventions on otitis media recurrence, recurrence frequency and total recurrence time

The Journal of Laryngology & Otology ◽

10.1017/s0022215112001338 ◽

2012 ◽

Vol 126 (9) ◽

pp. 874-885 ◽

Cited By ~ 11

Author(s):

K H Cheong ◽

S S M Hussain

Keyword(s):

Systematic Review ◽

Otitis Media ◽

Acute Otitis Media ◽

Prophylactic Antibiotics ◽

Recurrence Time ◽

Tympanostomy Tube ◽

Tube Insertion ◽

Hand Search ◽

Randomised Controlled ◽

Recurrence Frequency

AbstractObjective:To conduct a systematic review comparing the effect of three interventions (prophylactic antibiotics, tympanostomy tube insertion and adenoidectomy) on otitis media recurrence, recurrence frequency and total recurrence time.Methods:Literature on recurrent otitis media was identified using the PubMed and Scopus search engines for the period January 1990 to March 2011. A hand search of the reference lists of relevant articles and textbooks was conducted to identify additional studies. Randomised, controlled trials with a minimum of 40 children and follow up of at least 12 months were included.Results:Eighteen publications were identified. Each was assessed using preset inclusion criteria; seven publications met these criteria.Conclusion:Prophylactic antibiotics are effective in reducing otitis media recurrence, recurrence frequency and total recurrence time. Tympanostomy tube insertion failed to reduce the prevalence of otitis media recurrence, but reduced the recurrence frequency and total recurrence time. Adenoidectomy reduced otitis media recurrence; results on otitis media recurrence frequency differed but on average there was a reduction; however, the two studies with relevant data on total recurrence time had contradictory results.

Download Full-text