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Management for the children with otitis media with effusion in the tertiary hospital
Yun-Hoon Choung1, You Ree Shin, Seong Jun Choi
1Department of Otolaryngology, Ajou University School of Medicine, Yeongtong-gu, Suwon, Korea. yhc@ajou.ac.kr
Insights
Antibiotics and antihistamines showed no significant benefit for treating childhood otitis media with effusion (OME) in a tertiary hospital setting. Alternative guidelines, potentially including earlier surgical intervention, may be needed for effective OME management.
Area of Science:
- Pediatric Otolaryngology
- Evidence-Based Medicine
- Clinical Trials
Background:
- New evidence-based guidelines for otitis media with effusion (OME) exist.
- Tertiary hospitals face challenges implementing these general OME guidelines.
- This study addresses OME treatment efficacy in a tertiary care setting.
Purpose of the Study:
- To evaluate the effectiveness of antibiotics and antihistamines for treating OME in children within a tertiary hospital.
- To compare different medication protocols for OME management in a specialized healthcare environment.
Main Methods:
- A randomized prospective clinical study involving 84 children diagnosed with OME.
- Children received one of five treatments for 2 weeks: antibiotics, antibiotics/steroids, antibiotics/antihistamines, antibiotics/steroids/antihistamines, or mucolytics (control).
- Outcomes were assessed every 2 weeks, with a final evaluation at 3 months.
Main Results:
- Overall resolution rate was 42.9% within an average of 6.9 weeks; 42.9% required ventilation tube insertion, and 14.3% were observed.
- No significant differences in OME resolution rates were found among the five treatment protocols (P>0.05).
- No differences in resolution rates were observed in children with allergies treated with steroids, antihistamines, or combination therapies (P>0.05).
Conclusions:
- The cure rate for OME in this tertiary hospital was lower than expected.
- Antibiotics or anti-allergic medications did not demonstrate superior efficacy compared to the control group for OME.
- Revised guidelines, possibly incorporating earlier surgical intervention, may be necessary for tertiary hospital OME management.
Objectives:
Recently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study.
Methods:
Eighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months.
Results:
Thirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05).
Conclusion:
In the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals.
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