scholarly journals Comparing Watchful Waiting Approach vs. Antibiotic Therapy in Children with Nonsevere Acute Otitis Media: A Randomized Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Leila Shahbaznejad ◽  
Ensieh Talaei ◽  
Fatemeh Hosseinzadeh ◽  
Baraneh Masoumi ◽  
Shaghayegh Rezai ◽  
...  

Objective. To compare both approaches for the treatment of nonsevere acute otitis media (AOM) in Iran. Methods. This randomized clinical trial was performed at a pediatric infectious diseases clinic in Buali tertiary hospital in Sari, north of Iran, from 2016 to 2018. All participants in this study were previously healthy children with AOM diagnosis, who were 6 months to 6 years old. The patients were randomly assigned into two groups: the intervention (80 mg/kg/day amoxicillin for 7-10 days) and the control group (watchful waiting approach). AOM recovery and adverse drug reactions were evaluated after 72 hours, and the patients were followed for the frequency of AOM and middle ear effusion 1 and 3 months’ postintervention. Results. A total of 396 children have participated in this study. AOM recovery was significantly different in the two groups (73% vs. 44% in the intervention and control groups, respectively). Recurrence of AOM and middle ear effusion (MEE) persistence, one month following the intervention, have not shown any significant differences between the two groups. However, the AOM recurrence between 1 and 3 months was more frequent in the control group. The frequency of diarrhea was also higher in the intervention group compared to the control but no significant difference was found between the two groups regarding vomiting and skin rash. Conclusion. The faster recovery from AOM is achieved when an antibiotic treatment regimen is applied, although the risk of potential side effects should be considered.

1992 ◽  
Vol 106 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Lars-Eric Stenfors ◽  
Simo Räisänen

AbstractEpithelial cells were obtained by swabbing the posterior wall of the nasopharynx (NPH) of 15 patients (age one to 6 8/12; years; eight males, seven females) undergoing ENT-surgery under general anaesthesia for otitis media with effusion (OME). Individually matched, ear healthy children served as controls. Bacteria attached to the non-ciliated cells were calculated according to a method described. Furthermore, quantitative and qualitative bacteriological analyses were performed on samples obtained from mucoid middle ear effusion material as well as from the NPH. All patients and controls harboured middle ear pathogens (S. pneumoniae, H. influenzae, B. catarrhalis, or S. aureus) in the NPH. Only 33 per cent of the patients harboured middle ear pathogens in the middle ear effusion and the same pathogen was invariably found in the corresponding NPH Attachment of bacteria to the non-ciliated cells of the NPH diminished significantly with growing age in the ear healthy control group but not in the OME group. OME is closely correlated tothe presence of middle ear pathogens in the NPH and to attachment of bacteria to the epithelial cells in the NPH.


2018 ◽  
pp. 277-280
Author(s):  
Shannon Drohan

Acute otitis media (AOM) is a common cause of fever especially in the first two years of life. This condition can be easily diagnosed in a child with an acute illness by presence of middle ear effusion on exam in addition to signs of inflammation revealed by intense erythema or report of otalgia. Recent guidelines recommend a “watchful waiting” approach to treatment in certain patients to help reduce antibiotic usage as most cases of AOM resolve spontaneously. This strategy can be used in children >6 months old with non-severe symptoms, as long as follow-up is ensured to provide a rescue antibiotic if symptoms do not improve within 48-72 hours.


1984 ◽  
Vol 22 (14) ◽  
pp. 53-54

Acute suppurative otitis media (AOM) is a common, painful condition affecting 20% of children under 4 years at least once a year,1 and perhaps more in infancy when clinical examination is most difficult. Infectious complications such as mastoiditis, meningitis and cerebral abscess are now rare, but chronic middle ear effusion and hearing loss remain common. Hearing loss may persist long after the infective episode,2 and may impair learning.


1986 ◽  
Vol 100 (12) ◽  
pp. 1347-1350 ◽  
Author(s):  
T. H. J. Lesser ◽  
M. I. Clayton ◽  
D. Skinner

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).


2017 ◽  
Vol 9 (12) ◽  
pp. 1864-1871 ◽  
Author(s):  
O. D. Ayala ◽  
C. A. Wakeman ◽  
I. J. Pence ◽  
C. M. O'Brien ◽  
J. A. Werkhaven ◽  
...  

Raman microspectroscopy was used to characterize and identify the three main pathogens that cause acute otitis media (AOM)in vitro. Cultured middle ear effusion from patients was studied and results suggest the potential of using this technique to aid in accurately diagnosing AOM and providing physicians with bacterial identification to guide treatment.


2006 ◽  
Vol 95 (3) ◽  
pp. 359-363 ◽  
Author(s):  
Marjo Renko ◽  
Tero Kontiokari ◽  
Katariina Jounio-Ervasti ◽  
Heikki Rantala ◽  
Matti Uhari

2016 ◽  
Vol 7 (1) ◽  
pp. 17-22
Author(s):  
Ho Sandra ◽  
David J Kay

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.


1997 ◽  
Vol 16 (8) ◽  
pp. 816-817 ◽  
Author(s):  
Christopher J. Harrison ◽  
Stephen A. Chartrand ◽  
William Rodriguez ◽  
Richard Schwartz ◽  
Jay Pollack ◽  
...  

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