[Antibiotics and cortisone in the treatment of otitis media with effusion]

Persistent otitis media with effusion (OME) is a pathology very frequent in the first year of life and causes hearing loss which can be a negative factor in language and cognitive development and may result in disturbances in psychological adjustment. Generally OME has spontaneous resolution but if it persist for more than 3 months a medical or surgical treatment is compulsory. OME is frequently a result of recurrent otitis media and bacterial infection is considered to play a definitive causative role in the development of this pathology. A wide variety of medical treatments (antibiotics, aerosolized corticosteroids, oral antihistamine-decongestants, mucolytics) is indicative of lake of success. We have treated 60 children with OME with antibiotics (amoxicillin or cefaclor for 1 month) and oral steroids (prednisone for 7 days). All patients had a history for more than 3 months, without adenoid hypertrophy. Diagnosis of OME was established after pneumatic otoscopy, tympanometry and audiometry. Following the therapeutical association 53 patients showed a complete resolution of the effusion. At the follow-up after 2 months, 4 children had a recurrence of effusion. We consider this treatment with a short course of steroids and antibiotics and effective method before referral for tube placement.