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Clinical effects of clarithromycin on persistent inflammation following Haemophilus influenzae-positive acute otitis

Yukiko Iino1, Naohiro Yoshida, Toshinori Kato

  • 1Department of Otolaryngology, Jichi Medical University, Saitama Medical Center , Saitama.

Acta Oto-Laryngologica
|February 5, 2015
PubMed
Abstract

Insights

Clarithromycin (CAM) combined with carbocysteine (S-CMC) effectively reduced persistent middle ear inflammation after acute otitis media (AOM) in children. This combination therapy offers a valuable option for managing lingering ear inflammation and preventing chronic otitis media with effusion.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Pharmacology

Background:

  • Acute otitis media (AOM) is a common childhood infection.
  • Persistent middle ear inflammation and effusion can follow AOM, particularly when caused by Haemophilus influenzae.
  • Effective management strategies are needed to resolve inflammation and prevent chronic conditions.

Purpose of the Study:

  • To evaluate a novel treatment approach for persistent middle ear inflammation post-AOM in pediatric patients.
  • To compare the clinical efficacy of carbocysteine (S-CMC) alone versus S-CMC combined with clarithromycin (CAM) for persistent inflammation.
  • To assess the impact of clarithromycin on resolving residual otitis media with effusion.

Main Methods:

  • A clinical study involving children with H. influenzae-induced AOM treated with initial antimicrobial agents.
  • Patients with persistent middle ear effusion received a second-line treatment for one week: either S-CMC alone or S-CMC plus CAM.
  • Clinical outcomes were compared between the two treatment regimens.

Main Results:

  • Following initial acute treatment, many children still exhibited abnormal otoscopic findings.
  • No significant differences were observed immediately after the additional treatment period.
  • One week post-treatment, the clarithromycin plus S-CMC group showed a significantly lower prevalence of diminished light reflex (p=0.017) and a trend towards reduced tympanic membrane redness (p=0.097) compared to S-CMC alone.

Conclusions:

  • Additional treatment with clarithromycin (CAM) alongside carbocysteine (S-CMC) effectively reduces persistent middle ear inflammation after acute otitis media (AOM) caused by Haemophilus influenzae in children.
  • The combination therapy is a viable option for resolving lingering inflammation and preventing chronic otitis media with effusion.
  • Clarithromycin demonstrates a beneficial effect in resolving residual signs of middle ear inflammation following AOM.
Keywords:
Biofilmcell invasionclinical effects

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