Prevention of recurrent acute otitis media in otitis-prone children by intermittent prophylaxis with penicillin
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K Prellner1, M Foglé-Hansson, F Jørgensen
1Department of Oto-Rhino-Laryngology, University Hospital, Lund, Sweden.
Insights
Intermittent penicillin V (pcV) for upper respiratory tract infections (URTI) reduced recurrent acute otitis media (AOM) by 50% in young children. This approach offers a safe, rational alternative to continuous antibiotic prophylaxis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Recurrent acute otitis media (AOM) is common in otitis-prone children.
- Continuous antibiotic prophylaxis reduces AOM but raises concerns about antibiotic resistance and side effects.
- Intermittent antibiotic use may offer a balance between efficacy and reduced antibiotic consumption.
Purpose of the Study:
- To evaluate the efficacy of intermittent penicillin V (pcV) in preventing recurrent AOM in otitis-prone children.
- To compare intermittent pcV treatment during upper respiratory tract infections (URTI) with placebo.
- To assess the safety and potential for reduced antibiotic consumption with intermittent pcV therapy.
Main Methods:
- A double-blind, randomized, placebo-controlled multicentre study.
- Inclusion of 76 otitis-prone children under 18 months of age.
- Follow-up conducted from January to June, monitoring AOM episodes and URTI occurrences.
Main Results:
- A 50% reduction in AOM episodes was observed in children receiving intermittent pcV during URTI compared to the placebo group.
- A total of 123 AOM episodes were recorded across all participants.
- No significant ecological drawbacks or adverse effects were noted with the intermittent pcV regimen.
Conclusions:
- Intermittent administration of penicillin V (pcV) upon signs of URTI is an effective strategy for reducing recurrent AOM in otitis-prone children.
- This method appears to be a rational and safe approach, potentially decreasing overall antibiotic usage.
- The findings support intermittent pcV as a viable alternative to continuous antibiotic prophylaxis for managing recurrent AOM.
Abstract:
The question whether penicillin V (pcV) given intermittently upon signs of upper respiratory tract infections (URTI) in otitis-prone children might prevent recurrent bouts of acute purulent otitis media (AOM) is addressed. As compared with continuous long-term antibiotic treatment as prophylaxis in otitis-prone children, intermittent administration would reduce the overall consumption of antibiotics. Seventy-six otitis-prone children less than 18 months of age were included in this double-blind, randomized, placebo-controlled multicentre study. Follow-up was from January till June. One hundred and twenty-three episodes of AOM occurred. The number of AOM episodes was reduced by 50% in the children on pcV during URTI episodes as compared with those on placebo. No obvious ecological drawbacks were noted. Thus, the described mode of pcV administration seems to be a rational and safe way to reduce the number of AOM episodes in otitis-prone children.