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Nasopharyngeal bacterial flora in otitis prone children treated with immunoglobulin
F Jørgensen1, B Andersson, S Larsson
1Department of Clinical Immunology, University of Göteborg, Sweden.
Insights
Long-term immunoglobulin prophylaxis did not prevent recurrent acute otitis media (RAOM) in young children. This treatment also failed to alter nasopharyngeal bacterial flora or the incidence of otitis media with effusion (OME).
Area of Science:
- Pediatrics
- Immunology
- Otolaryngology
Background:
- Recurrent acute otitis media (RAOM) is common in children under two.
- Identifying effective preventative strategies is crucial for reducing disease burden.
Purpose of the Study:
- To evaluate the efficacy of long-term immunoglobulin prophylaxis in preventing RAOM in young children.
- To assess the impact of immunoglobulin on nasopharyngeal bacterial flora and otitis media incidence.
Main Methods:
- A randomized controlled trial involving 44 children under two with RAOM.
- Children received either intramuscular immunoglobulin or a placebo for six months.
- Nasopharyngeal flora, acute otitis media (AOM), and secretory otitis media (SOM) were monitored for 12 months.
Main Results:
- Immunoglobulin prophylaxis did not significantly reduce the frequency of AOM or SOM.
- No significant changes were observed in the nasopharyngeal bacterial flora composition.
- Children with otitis media more frequently harbored bacterial pathogens compared to controls.
Conclusions:
- Long-term immunoglobulin prophylaxis is not effective in preventing RAOM in children under two.
- The study did not find evidence that immunoglobulin influences nasopharyngeal bacterial colonization patterns.
Abstract:
The present study was undertaken to evaluate possible beneficial effects of regularly given, long term immunoglobulin prophylaxis of children below 2 years of age with recurrent acute otitis media (RAOM). The nasopharyngeal bacterial flora and the frequency of acute otitis media (AOM) and secretory otitis media SOM were studied. Every second of 44 children with 3 or more periods of AOM during the last year received immunoglobulin intramuscularly (Gammaglobulin Kabi 165 mg/l, 0.45 ml/kg b.w.) every third week for 6 months, while the other 22 children served as controls. All children were followed for 12 months. Immunoglobulin prophylaxis neither influenced the nasopharyngeal flora, nor the frequency of AOM or SOM periods. Children with AOM or SOM more often harbored bacterial pathogens in their nasopharynx than children with normal middle ear status. Also, the immunoglobulin prophylaxis did not influence the increased frequency of bacterial pathogens in the nasopharynx of children attending public day care or family day care as compared to those taken care of at home.