Low dose macrolide administration for long term is effective for otitis media with effusion in children
ABSTRACT OBJECTIVE: To explore the clinical effect and possible mechanism of macrolides on otitis media with effusion in children. METHODS: Children with otitis media with effusion were recruited and prescribed for macrolides according to a designed scheme, and followed up for 8-12 weeks. Middle ear effusion samples were collected from the participants to assess the presence of biofilm. RESULTS: Macrolides were found to have significant effect on the therapy of early stage otitis media with effusion for 88.7-92.5% of participants compared with 50.9-60.3% in control group after 8-12 weeks. Almost 72.1% of chronic otitis media with effusion patients recovered after an 8 weeks' course low dose macrolides prescription. Biofilm occurred in 30.8% (4/13) of middle ear effusion. CONCLUSIONS: The results indicate that macrolides are effective for otitis media with effusion in children. Bacterial biofilm may play an important role in the pathogenesis of otitis media with effusion.
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ABSTRACT: Recurrent respiratory tract infections (RRTIs) are very common in children and a major challenge for pediatricians. In the last few years, bacterial biofilms have been linked to RRTIs and antibiotic resistance, and have raised serious concerns regarding the therapeutic management of recurrent middle ear diseases, chronic rhinosinusitis, and recurrent pharyngotonsillitis. This paper aims to review the new insights into biofilm-related upper respiratory tract infections in children and possible therapeutic strategies. It focuses on the clinical implications for recurrent disease and on studies in pediatric patients. Analysis of the literature showed that the involvement of bacterial biofilm in recurrent upper airway tract infections is an emerging problem that may lead to serious concerns about infection control. Despite the large amount of research within this field, detailed insight into the complex structure of bacterial biofilms and the ultrastructural and biochemical mechanisms responsible for its evasion of the immune system and resistance to treatments is currently lacking. In the future, additional emphasis should be placed on biofilm management as a component of therapeutic strategies. This goal can be attained by finding feasible methods for detecting biofilms in vivo and identifying effective methods for administering treatments that eradicate preexisting bacterial biofilms or hinder bacterial adhesion to respiratory cells.European Journal of Clinical Microbiology 10/2014; 34(3). DOI:10.1007/s10096-014-2261-1 · 2.54 Impact Factor
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ABSTRACT: Abstract Conclusion: Additional treatment with clarithromycin (CAM) reduced persistent middle ear inflammation after acute otitis media (AOM) caused by Haemophilus influenzae in children. CAM is a treatment option for persistent inflammation following AOM and to prevent continuing otitis media with effusion. We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children. H. influenzae-infected children with AOM were treated acutely with antimicrobial agents, after which those still demonstrating effusion of the middle ear cavity received additional treatment with carbocysteine (S-CMC) alone or S-CMC combined with clarithromycin (CAM) for 1 week. The two regimens were compared in terms of clinical effects. After the initial acute treatment, many patients still showed abnormal otoscopic findings. At the completion of additional treatment, there were no significant differences between the two treatment groups. However, 1 week after completion of additional treatment, the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group (p = 0.017). The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug (p = 0.097).Acta Oto-Laryngologica 03/2015; 135(3):217-25. DOI:10.3109/00016489.2014.975893 · 0.99 Impact Factor