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Updated: Jul 27, 2026
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Therapy for otitis-prone children in Tenshi hospital
M Matsumura1, S Fukuda, E Chida
1Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo, Japan. michey@med.hokudai.ac.jp
Insights
Recurrent infant otitis media is often caused by drug-resistant Streptococcus pneumoniae. Low specific IgG2 antibody levels, not IgG2 subclass deficiency, contribute to persistent infections, improving with immunoglobulin therapy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Recurrent otitis media in infants presents challenges due to increasing antibiotic resistance.
- Multiple-drug-resistant Streptococcus pneumoniae is a growing concern in pediatric infections.
Purpose of the Study:
- To investigate the causative bacteria in infant otitis media.
- To assess immune status, specifically IgG subclass and specific IgG2 antibody, in infants with recurrent otitis media.
- To evaluate the efficacy of immunoglobulin therapy for intractable cases.
Main Methods:
- Bacterial investigation of otitis media cases in infants treated between January and December 1997.
- Measurement of IgG subclass and specific IgG2 antibody levels against S. pneumoniae in six severe cases.
- Clinical observation of treatment outcomes, including immunoglobulin substitute therapy.
Main Results:
- Streptococcus pneumoniae identified in 45% of initial otitis media cases.
- Penicillin resistance was observed in 88% of identified S. pneumoniae strains.
- All cases showed low specific IgG2 antibody levels; only one case had IgG2 subclass deficiency.
- Two patients showed significant improvement with immunoglobulin substitute therapy.
Conclusions:
- Low specific IgG2 antibody levels to S. pneumoniae are implicated in recurrent otitis media pathogenesis.
- Immunoglobulin therapy shows promise for treating intractable recurrent otitis media in infants.
- The study highlights the need for alternative treatment strategies beyond standard antibiotics.
Abstract:
With the recent emergence and increases of multiple-drugs-resistant Streptococcus pneumoniae, we have been seeing an increasing number of infants with intractable recurrent otitis media which is resistant to the general conservative out-patient treatments such as oral administration of medicines or tympanotomy. In this study, we investigated the inflammation-causing bacteria in the infants with otitis media which were treated in our hospital from January to December in 1997, and in six serious cases among them, we measured IgG subclass and specific IgG2 antibody to S. pneumoniae to examine them. As a result, S. pneumoniae was found to be the cause in 45% of the cases of initial development of otitis media, and in 88% of them the S. pneumoniae was penicillin-resistant. The level of specific IgG2 antibody to S. pneumoniae was low in all the cases, whereas IgG2 subclass was deficient only in one out of the six cases; from these findings, the selectively low level of immune status was thought to be the cause of the recurrences of otitis media. In two cases, clinical condition was markedly improved by immunoglobulin substitute therapy, which demonstrates that immunoglobulin is effective for the intractable recurrent otitis media in infants.
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