Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-09T22:04:38.016Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  05 July 2012

K H Cheong
Affiliation:
Department of Otolaryngology, Ninewells Hospital and University of Dundee Medical School, Dundee, Scotland, UK
S S M Hussain*
Affiliation:
Department of Otolaryngology, Ninewells Hospital and University of Dundee Medical School, Dundee, Scotland, UK
*
Address for correspondence: Mr S S Musheer Hussain, Consultant Otologist & Neurotologist, Honorary Reader, Ward 26, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK Fax: +44 (0)1382 632 816 E-mail: [email protected]

Abstract

Objective:

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.

Type
Review Article
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Rea, P, Graham, J. Acute otitis media in children. In: Gleeson, MJ, Jones, NS, Burton, MJ, Clarke, R, Browning, GG, eds. Scott-Brown's Otorhinolaryngology. London: Hodder Education, 2008;912–27Google Scholar
2Teele, DW, Klein, JO, Rosner, B. Epidemiology of otitis media using the first seven years of life in children in Greater Boston: a prospective, cohort study. J Infect Dis 1989;160:8394CrossRefGoogle ScholarPubMed
3Teele, DW, Klein, JO, Chase, C, Menyuk, P, Rosner, BA, Greater Boston Otitis Media Study Group. Otitis media in infancy and intellectual ability, school achievement, speech, and language at age 7 years. J Infect Dis 1990;162:685–94CrossRefGoogle ScholarPubMed
4Morris, PS, Leach, AJ. Managing otitis media: an evidence-based approach. Australian Prescriber 2009;32:155–9CrossRefGoogle Scholar
5Casselbrant, ML, Kaleida, PH, Rockette, HE, Paradise, JL, Bluestone, CD, Kurs-Lasky, M et al. Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media: results of a randomized clinical trial. Pediatr Infect Dis J 1992;11:278–86Google Scholar
6Hammaren-Malmi, S, Saxen, H, Tarkkanen, J, Mattila, PS. Adenoidectomy does not significantly reduce the incidence of otitis media in conjunction with the insertion of tympanostomy tubes in children who are younger than 4 years: a randomized trial. Pediatrics 2005;116:185–9CrossRefGoogle Scholar
7De Diego, JI, Prim, MP, Alfonso, C, Sastre, N, Rabanal, I, Gavilan, J. Comparison of amoxicillin and azithromycin in the prevention of recurrent acute otitis media. Int J Pediatr Otorhinolaryngol 2001;58:4751Google Scholar
8Mattila, PS, Joki-Erkkila, V, Kilpi, T, Jokinen, J, Herva, E, Puhakka, H. Prevention of otitis media by adenoidectomy in children younger than 2 years. Arch Otolaryngol Head Neck Surg 2003;129:163–8CrossRefGoogle Scholar
9Marchisio, P, Principi, N, Sala, E, Lanzoni, L, Sorella, S, Massimini, A. Comparative study of once-weekly azithromycin and once-daily amoxicillin treatments in prevention of recurrent acute otitis media in children. Antimicrob Agents Chemother 1996;40:2732–6Google Scholar
10El-sayed, Y. Treatment of recurrent acute otitis media chemoprophylaxis versus ventilation tubes. Aust J Otolaryngol 1996;2:352–5Google Scholar
11Valtonen, H, Qvarnberg, Y, Nuutinen, J. Tympanostomy in young children with recurrent otitis media. A long-term follow-up study. J Laryngol Otol 1999;113:207–11CrossRefGoogle ScholarPubMed
12Pereira, MBR, Pereira, DRR, da Costa, SS. Tympanostomy tube sequelae in children with otitis media with effusion: a three-year follow-up study. Braz J Otorhinolaryngol 2005;71:415–20CrossRefGoogle ScholarPubMed
13Autret-Leca, E, Giraudeau, B, Ployet, MJ, Jonville-Bera, AP. Amoxicillin/clavulanic acid is ineffective at preventing otitis media in children with presumed viral upper respiratory infection: a randomized, double-blind equivalence, placebo-controlled trial. Brit J Clin Pharmacol 2002;54:652–6CrossRefGoogle ScholarPubMed
14Prellner, K, Fogle-Hansson, M, Jorgensen, F, Kalm, O, Kamme, C. Prevention of recurrent acute otitis media in otitis-prone children by intermittent prophylaxis with penicillin. Acta Otolaryngol 1994;114:182–7CrossRefGoogle ScholarPubMed
15Roark, R, Berman, S. Continuous twice daily or once daily amoxicillin prophylaxis compared with placebo for children with recurrent acute otitis media. Pediatr Infect Dis J 1997;16:376–81CrossRefGoogle ScholarPubMed
16Kaleida, PH, Casselbrant, M, Rockette, HE, Paradise, JL, Bluestone, CD, Blatter, MM et al. Amoxicillin or myringotomy or both for acute otitis media: results of a randomized clinical trial. Pediatrics 1991;87:466–74CrossRefGoogle ScholarPubMed
17Teele, DW, Klein, JO, Word, BM, Rosner, BA, Starobin, S, Earle, R et al. Antimicrobial prophylaxis for infants at risk for recurrent acute otitis media. Vaccine 2001;19(suppl 1):S140–3CrossRefGoogle Scholar
18Mandel, E, Casselbrant, M, Rockette, H, Bluestone, C, Kurslasky, M. Efficacy of antimicrobial prophylaxis for recurrent middle ear effusion. Pediatr Infect Dis J 1996;15:1074–82Google Scholar
19Paradise, JL, Bluestone, CD, Rogers, KD, Taylor, FH, Colborn, K, Bachman, RZ et al. Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement. Results of parallel randomized and nonrandomized trials. JAMA 1990;263:2066–73CrossRefGoogle ScholarPubMed
20Paradise, JL, Bluestone, CD, Colborn, DK, Bernard, BS, Smith, CG, Rockette, HE et al. Adenoidectomy and adenotonsillectomy for recurrent acute otitis media. Parallel randomized clinical trials in children not previously treated with tympanostomy tubes. JAMA 1999;282:945–53CrossRefGoogle Scholar
21Le, CT, Freeman, DW, Fireman, BH. Evaluation of ventilating tubes and myringotomy in the treatment of recurrent or persistent otitis media. Pediatr Infect Dis J 1991;10:211CrossRefGoogle ScholarPubMed
22Casselbrant, ML, Kaleida, PH, Rockette, HE, Paradise, JL, Bluestone, CD, Kurs-Lasky, M et al. Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media: results of a randomized clinical trial. Pediatr Infect Dis J 1992;11:278–86CrossRefGoogle ScholarPubMed
23Koivunen, P, Uhari, M, Luotonen, J, Kristo, A, Raski, R, Pokka, T et al. Adenoidectomy versus chemoprophylaxis and placebo for recurrent acute otitis media in children aged under 2 years: randomised controlled trial. BMJ 2004;328:487–92CrossRefGoogle ScholarPubMed
24Hussain, SSM. Extrusion rate of Shah and Sheppard ventilation tubes in children. Ear Nose Throat J 1992;71:273–5CrossRefGoogle Scholar
25Stool, SE, Randall, P. Unexpected ear disease in infants with cleft palate. Cleft Palate Journal 1967;4:99103Google Scholar
26Maheshwar, AA, Milling, MAP, Kumar, M, Clayton, MI, Thomas, A. Use of hearing aids in the management of children with cleft palate. Int J Pediatr Otorhinolaryngol 2002;66:5562Google Scholar
27Shott, SR. Down syndrome: common otolaryngologic manifestations. Am J Med Genet C Semin Med Genet 2006;142C:131–40CrossRefGoogle ScholarPubMed
28Klein, JO. Otitis media. Clin Infect Dis 1994;19:823–33CrossRefGoogle ScholarPubMed