EFFECTIVENESS OF PROLONGED ANTIBIOTIC THERAPY IN CHILDREN WITH EXUDATIVE OTITIS MEDIA
Keywords:
Otitis media, exudative otitis, antibiotic therapy, amoxicillin, pathogen colonization, pediatric, healthcare accessAbstract
Otitis media (OM) remains a significant health issue, particularly in Central Asia and Russia, where access to healthcare is limited. This study aimed to compare the effectiveness of long-term antibiotic therapy (amoxicillin) versus placebo in treating exudative otitis media (EOM) and assess the colonization by antibiotic-resistant pathogens. Conducted at Samarkand State Medical University, the study involved 100 children under 12 months old. Participants were randomized to receive either amoxicillin or placebo for up to 24 weeks. The primary outcome was the restoration of normal middle ear aeration, confirmed by tympanometry. Results showed fewer tympanic membrane perforations and a higher success rate in the amoxicillin group. Pathogen carriage was reduced in the antibiotic group without a significant increase in resistant strains. Prolonged antibiotic therapy may benefit high-risk children in regions with limited healthcare access.
References
Mahadevan M, Navarro-Locsin G, Tan HK, Yamanaka N, Sonsuwan N, Wang PC, Dung NT, Restuti RD, Hashim SS, Vijayasekaran S. A review of the burden of disease due to otitis media in the Asia-Pacific. International Journal of Pediatric Otorhinolaryngology. 2012 May 1;76(5):623-35.
Ren Y, Sethi RK, Stankovic KM. Acute otitis media and associated complications in United States emergency departments. Otology & Neurotology. 2018 Sep 1;39(8):1005-11.
Atkinson H, Wallis S, Coatesworth AP. Acute otitis media. Postgraduate medicine. 2015 Jul 4;127(4):386-90.
Mayanskiy N, Alyabieva N, Ponomarenko O, Pakhomov A, Kulichenko T, Ivanenko A, Lazareva M, Lazareva A, Katosova L, Namazova-Baranova L, Baranov A. Bacterial etiology of acute otitis media and characterization of pneumococcal serotypes and genotypes among children in Moscow, Russia. The Pediatric infectious disease journal. 2015 Mar 1;34(3):255-60.
Tamir SO, Shemesh S, Oron Y, Marom T. Acute otitis media guidelines in selected developed and developing countries: uniformity and diversity. Archives of Disease in Childhood. 2017 May 1;102(5):450-7.
DeAntonio R, Yarzabal JP, Cruz JP, Schmidt JE, Kleijnen J. Epidemiology of otitis media in children from developing countries: A systematic review. International Journal of Pediatric Otorhinolaryngology. 2016 Jun 1;85:65-74.
Kosyakov SI, Minavnina JV, Phillips JS, Yung MW. International recognition of the chronic otitis media questionnaire 12. The Journal of Laryngology & Otology. 2017 Jun;131(6):514-7.
Phillips JS, Yung MW, Nunney I, Doruk C, Kara H, Kong T, Quaranta N, Peñaranda A, Bernardeschi D, Dai C, Kania R. Multinational appraisal of the chronic otitis media questionnaire 12 (COMQ-12). Otology & Neurotology. 2021 Jan 1;42(1):e45-9.
Korona-Glowniak I, Wisniewska A, Juda M, Kielbik K, Niedzielska G, Malm A. Bacterial aetiology of chronic otitis media with effusion in children-risk factors. Journal of Otolaryngology-Head & Neck Surgery. 2020 Jan;49(1):24.
Vishwanath S, Mukhopadhyay C, Prakash R, Pillai S, Pujary K, Pujary P. Chronic suppurative otitis media: Optimizing initial antibiotic therapy in a tertiary care setup. Indian Journal of Otolaryngology and Head & Neck Surgery. 2012 Sep;64:285-9.
Frost HM, Bizune D, Gerber JS, Hersh AL, Hicks LA, Tsay SV. Amoxicillin versus other antibiotic agents for the treatment of acute otitis media in children. The Journal of pediatrics. 2022 Dec 1;251:98-104.