Efficacy Of Antibiotics Plus Oral Steroids With Nasal Spray Steroids For The Treatment Of Persistent Otitis Media With Effusion In Children

Introduction:Otitis media with effusion(OME) in children is a common disease in ENT Clinics. Conductive hearing impairment which may induce delay of language learning may be caused by OME.Persistence of OME for more than three months is an indication for ventilation tube insertion.This operation requires general anesthesia(GA) and may result in some complications such as tympanosclerosis and post-operative persistent otorrhea.Therefore, another clinical treatment was tried to avoid the performance of operation.Methods:This study was conducted in a random manner.Between September 2005 and July 2008,pediatric patients diagnosed with OME more than two months were collected in this survey.Thirty children given only cefixime for seven days were enrolled in the controlled group.Another thirty children were enrolled in the treatment group.They received prednisolone for three days,Fluticasone propionate nasal spray for one month,and cefixime for seven days.Effects were analyzed and relative factors were evaluated in two to four weeks such as sex,age,unilateral or bilateral sides,effusion duration,and history of allergic rhinifis(AR) or chronic paranasol sinusitis(CPS).Results:The resolution rates of the treatment and controlled quoupe wwre 43.3%and 16.6% respectively.The statistical analysis revealed significant difference(P＜0.05) between the two groups.However,other factors between the two quoups were not significantly different such as sex,age,unilateral or bilateral sides,effusion duration,and history of AR or CPS.Conclusions:A short course treatment with oral steroid,nasal spray steroid,and beta-lactamase stable antibiotics provides a synergistic effect which enables cure of OME in selected children before surgey.Consequently the treatment combing oral steroid,nasal spray steroid,and antibiotics is an effective alternative to surgical intervention for persistent OME.