Background Middle ear infections are common, especially among young children, usually causing earache and some temporary (occasionally permanent) hearing loss. Zinc is an essential micronutrient, which has a role in the optimal functioning of the immune system and resistance to infection. It must be consumed regularly as it cannot be stored in the body. Some people, especially children in low- and middle-income countries, may not have adequate zinc intake from food alone. Researchers have examined the potential role of zinc supplements in preventing infective illnesses. Therefore we wanted to discover whether zinc supplements have any role in preventing middle ear infections. Study characteristics The review authors searched the medical literature for studies up to March 2014. We searched for trials which compared middle ear infections in people randomly selected to receive zinc supplements or who did not receive supplements. We found 10 eligible studies, all conducted amongst young children. The total number of participants was 6820. Nine trials were conducted in low- and middle-income countries. Seven trials were conducted on healthy children. Participants included both males and females. Results The results of the trials provided no convincing evidence that zinc supplements reduce the occurrence of middle ear infections in healthy children. However, in one small study of severely malnourished children, those receiving zinc supplements had fewer middle ear infections. The only adverse effect was vomiting. Quality of evidence The trial evidence included is generally of good quality, with a low risk of bias. All the included trials included otitis media only as a secondary outcome. Therefore, there was a potential to miss trials which were less publicised or less well indexed within the electronic databases.
[Show abstract][Hide abstract] ABSTRACT: Background and Objectives Otitis media (OM) is one of the most common reasons for antibiotic treatment in children. Controversies regarding antibiotic treatment for OM have accumulated in the past decade, and there seem to be more dilemmas than certainties. The objectives of this article are to provide the state-of-the art review on achievements in treatment of all different stages of OM, including acute otitis media (AOM), otitis media with effusion (OME), and chronic suppurative otitis media, and to outline the future research areas. Data Sources PubMed, Ovid Medline, the Cochrane Database, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to OM treatment published in English between January 2007 and June 2011 were identified. A total of 286 articles related to OM treatment were reviewed by the panel members; 114 relevant quality articles were identified and summarized. Results New evidence emerged on beneficial results of antibiotic treatment, compared with observation of AOM in young children who were diagnosed based on stringent criteria. In OME, the main results were related to a nonsignificant benefit of adenoidectomy versus tympanostomy tube placement alone in the treatment of chronic OME in younger children. Other modalities of OM treatment were studied and described herein. Conclusions and Implications for Practice Significant progress has been made in advancing the knowledge on the treatment of OM. Areas of potential future research have been identified and outlined.
Otolaryngology Head and Neck Surgery 04/2013; 148(4 Suppl):E102-21. DOI:10.1177/0194599812465397 · 2.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Prebiotics, defined as nondigestible dietary ingredients resistant to gastric acidity and fermented by the intestinal flora, are used to positively influence the composition of intestinal flora, thereby promoting health benefits. The objective of this systematic review was to assess the efficacy of prebiotics in the prevention of acute infectious diseases in children. A systematic literature search was conducted using the Ovid Medline, Scopus, Web of Science, and Cochrane Library's Central databases. Finally, five randomized controlled trials, all of them investigating infants and children 0-24 months of age, were included in the review. Pooled estimates from three studies revealed a statistically significant decrease in the number of infectious episodes requiring antibiotic therapy in the prebiotic group as compared with the placebo group (rate ratio 0.68; 95% confidence interval 0.61-0.77). Studies available indicate that prebiotics may also be effective in decreasing the rate of overall infections in infants and children 0-24 months of age. Further studies in the age group 3-18 years are required to determine whether prebiotics can be considered for the prevention of acute infectious diseases in the older pediatric population.
[Show abstract][Hide abstract] ABSTRACT: Background & aims:
It is estimated that zinc deficiency is responsible for 4.4% of childhood deaths in Africa, Asia, and Latin America. This review examines the impact of zinc supplementation, administered prophylactically or therapeutically, on diarrhoea.
Relevant published articles were identified through systematic searches of electronic databases. Bibliographies of retrieved articles were examined.
A total of 38 studies were included in this review, 29 studies examined the effect of prophylactic zinc and nine studies examined the effects of therapeutic use of zinc for treatment of diarrhoea in children under five years.
Prophylactic zinc has been shown to be effective in decreasing both prevalence and incidence of diarrhoea, reducing respiratory infections and improving growth in children with impaired nutritional status. There is less conclusive evidence of reduction in diarrhoea duration or diarrhoea severity. While prophylactic zinc decreases mortality due to diarrhoea and pneumonia, it has not been shown to affect overall mortality. Therapeutic use of zinc for the treatment of diarrhoea in children has been shown to reduce diarrhoea incidence, stool frequency and diarrhoea duration as well as respiratory infections in zinc deficient children. However, stool output is only reduced in children with cholera. Less conclusive evidence exists for therapeutic zinc reducing mortality due to diarrhoea and respiratory infections. Specific definitions of diarrhoea severity, respiratory infection in further studies as well as examination of prophylactic zinc effectiveness in diarrhoea duration and severity effectiveness of therapeutic zinc in reducing mortality due to diarrhoea and respiratory infections are warranted.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.