Document Detail

Tube associated otorrhea in children with recurrent acute otitis media; results of a prospective randomized study on bacteriology and topical treatment with or without systemic antibiotics.
MedLine Citation:
PMID:  18565598     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To establish if otorrhea associated to tympanostomy tubes in infants suffering from recurrent acute otitis media is similar to acute otitis media, and if topical treatment alone is sufficient or if addition of systemic antibiotics is required. METHODS: Children under 3 years of age with tympanostomy tubes due to recurrent acute otitis media were recruited to the study. The study design was open label randomized and prospective. Fifty patients were allocated to either of two treatment groups and were monitored for 6 months. Group I received only topical treatment (commercially available ear drops and saline solution) in case of otorrhea. Group II was treated with topical treatment together with systemic antibiotics. All episodes of acute otorrhea were registered. Main outcome measure was duration of otorrhea in days. Bacterial samples from the ear discharge were taken. RESULTS: Forty-one episodes were treated according to protocol. The bacteriological testing mainly showed bacteria typical of acute otitis media. A majority of episodes were cured within 7 days in both groups, and statistical analysis showed no significant difference between the treatment groups in duration of otorrhea. In Group I systemic antibiotics were added in one-third (7/21) of the episodes due to signs of affected general condition such as high fever and severe earache. CONCLUSIONS: The otorrhea episodes in the study were similar to acute otitis media based on the bacteriological results. Topical treatment alone might be used as first treatment of choice. Although systemic antibiotics were added in several cases in the topical treatment group, the findings of the study do not support use of systemic antibiotics for tube associated otorrhea in RAOM children in general.
Anna Granath; Britta Rynnel-Dagöö; Magnus Backheden; Karin Lindberg
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-06-20
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  72     ISSN:  0165-5876     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  1225-33     Citation Subset:  IM    
Karolinska Institutet, Department of Clinical Science, Intervention and Technology and Ear-, Nose-, Throat- and Cochlear Department at Karolinska University Hospital Huddinge, Stockholm, Sweden.
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MeSH Terms
Acute Disease
Administration, Topical
Anti-Bacterial Agents / administration & dosage*
Child, Preschool
Middle Ear Ventilation / adverse effects*
Otitis Media with Effusion / etiology,  microbiology*,  surgery,  therapy*
Otitis Media, Suppurative / etiology,  microbiology*,  surgery,  therapy*
Prospective Studies
Reg. No./Substance:
0/Anti-Bacterial Agents

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