A Trial of Treatment for Acute Otorrhea in Children with Tympanostomy Tubes
Appropriate treatment of acute uncomplicated otorrhea in children with tympanostomy tubes is unclear. In this trial involving 230 children in the Netherlands, antibiotic–glucocorticoid eardrops were superior to oral amoxicillin–clavulanate or initial observation. The insertion of tympanostomy tubes...
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| Vydáno v: | The New England journal of medicine Ročník 370; číslo 8; s. 723 - 733 |
|---|---|
| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Waltham, MA
Massachusetts Medical Society
20.02.2014
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| ISSN: | 0028-4793, 1533-4406, 1533-4406 |
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| Abstract | Appropriate treatment of acute uncomplicated otorrhea in children with tympanostomy tubes is unclear. In this trial involving 230 children in the Netherlands, antibiotic–glucocorticoid eardrops were superior to oral amoxicillin–clavulanate or initial observation.
The insertion of tympanostomy tubes is one of the most frequently performed surgical procedures in children.
1
The main indications for this procedure are the restoration of hearing in children with persistent otitis media with effusion and the prevention of recurrences in children who have recurrent acute otitis media.
2
Acute otorrhea is a common sequela in children with tympanostomy tubes, with reported incidence rates ranging from 26% in a meta-analysis of mainly observational studies (involving cases of clinically manifested otorrhea) to 75% in a randomized trial (which included asymptomatic and subclinical cases).
3
–
5
Acute tympanostomy-tube otorrhea may be accompanied by foul . . . |
|---|---|
| AbstractList | BackgroundRecent guidance for the management of acute otorrhea in children with tympanostomy tubes is based on limited evidence from trials comparing oral antibiotic agents with topical antibiotics.MethodsIn this open-label, pragmatic trial, we randomly assigned 230 children, 1 to 10 years of age, who had acute tympanostomy-tube otorrhea to receive hydrocortisone–bacitracin–colistin eardrops (76 children) or oral amoxicillin–clavulanate suspension (77) or to undergo initial observation (77). The primary outcome was the presence of otorrhea, as assessed otoscopically, 2 weeks after study-group assignment. Secondary outcomes were the duration of the initial otorrhea episode, the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up, quality of life, complications, and treatment-related adverse events.ResultsAntibiotic–glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes. At 2 weeks, 5% of children treated with antibiotic–glucocorticoid eardrops had otorrhea, as compared with 44% of those treated with oral antibiotics (risk difference, −39 percentage points; 95% confidence interval [CI], −51 to −26) and 55% of those treated with initial observation (risk difference, −49 percentage points; 95% CI, −62 to −37). The median duration of the initial episode of otorrhea was 4 days for children treated with antibiotic–glucocorticoid eardrops versus 5 days for those treated with oral antibiotics (P<0.001) and 12 days for those who were assigned to initial observation (P<0.001). Treatment-related adverse events were mild, and no complications of otitis media, including local cellulitis, perichondritis, mastoiditis, and intracranial complications, were reported at 2 weeks.ConclusionsAntibiotic–glucocorticoid eardrops were more effective than oral antibiotics and initial observation in children with tympanostomy tubes who had uncomplicated acute otorrhea. (Funded by the Netherlands Organization for Health Research and Development; Netherlands Trial Register number, NTR1481.) Recent guidance for the management of acute otorrhea in children with tympanostomy tubes is based on limited evidence from trials comparing oral antibiotic agents with topical antibiotics. In this open-label, pragmatic trial, we randomly assigned 230 children, 1 to 10 years of age, who had acute tympanostomy-tube otorrhea to receive hydrocortisone-bacitracin-colistin eardrops (76 children) or oral amoxicillin-clavulanate suspension (77) or to undergo initial observation (77). The primary outcome was the presence of otorrhea, as assessed otoscopically, 2 weeks after study-group assignment. Secondary outcomes were the duration of the initial otorrhea episode, the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up, quality of life, complications, and treatment-related adverse events. Antibiotic-glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes. At 2 weeks, 5% of children treated with antibiotic-glucocorticoid eardrops had otorrhea, as compared with 44% of those treated with oral antibiotics (risk difference, -39 percentage points; 95% confidence interval [CI], -51 to -26) and 55% of those treated with initial observation (risk difference, -49 percentage points; 95% CI, -62 to -37). The median duration of the initial episode of otorrhea was 4 days for children treated with antibiotic-glucocorticoid eardrops versus 5 days for those treated with oral antibiotics (P<0.001) and 12 days for those who were assigned to initial observation (P<0.001). Treatment-related adverse events were mild, and no complications of otitis media, including local cellulitis, perichondritis, mastoiditis, and intracranial complications, were reported at 2 weeks. Antibiotic-glucocorticoid eardrops were more effective than oral antibiotics and initial observation in children with tympanostomy tubes who had uncomplicated acute otorrhea. (Funded by the Netherlands Organization for Health Research and Development; Netherlands Trial Register number, NTR1481.). Recent guidance for the management of acute otorrhea in children with tympanostomy tubes is based on limited evidence from trials comparing oral antibiotic agents with topical antibiotics.BACKGROUNDRecent guidance for the management of acute otorrhea in children with tympanostomy tubes is based on limited evidence from trials comparing oral antibiotic agents with topical antibiotics.In this open-label, pragmatic trial, we randomly assigned 230 children, 1 to 10 years of age, who had acute tympanostomy-tube otorrhea to receive hydrocortisone-bacitracin-colistin eardrops (76 children) or oral amoxicillin-clavulanate suspension (77) or to undergo initial observation (77). The primary outcome was the presence of otorrhea, as assessed otoscopically, 2 weeks after study-group assignment. Secondary outcomes were the duration of the initial otorrhea episode, the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up, quality of life, complications, and treatment-related adverse events.METHODSIn this open-label, pragmatic trial, we randomly assigned 230 children, 1 to 10 years of age, who had acute tympanostomy-tube otorrhea to receive hydrocortisone-bacitracin-colistin eardrops (76 children) or oral amoxicillin-clavulanate suspension (77) or to undergo initial observation (77). The primary outcome was the presence of otorrhea, as assessed otoscopically, 2 weeks after study-group assignment. Secondary outcomes were the duration of the initial otorrhea episode, the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up, quality of life, complications, and treatment-related adverse events.Antibiotic-glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes. At 2 weeks, 5% of children treated with antibiotic-glucocorticoid eardrops had otorrhea, as compared with 44% of those treated with oral antibiotics (risk difference, -39 percentage points; 95% confidence interval [CI], -51 to -26) and 55% of those treated with initial observation (risk difference, -49 percentage points; 95% CI, -62 to -37). The median duration of the initial episode of otorrhea was 4 days for children treated with antibiotic-glucocorticoid eardrops versus 5 days for those treated with oral antibiotics (P<0.001) and 12 days for those who were assigned to initial observation (P<0.001). Treatment-related adverse events were mild, and no complications of otitis media, including local cellulitis, perichondritis, mastoiditis, and intracranial complications, were reported at 2 weeks.RESULTSAntibiotic-glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes. At 2 weeks, 5% of children treated with antibiotic-glucocorticoid eardrops had otorrhea, as compared with 44% of those treated with oral antibiotics (risk difference, -39 percentage points; 95% confidence interval [CI], -51 to -26) and 55% of those treated with initial observation (risk difference, -49 percentage points; 95% CI, -62 to -37). The median duration of the initial episode of otorrhea was 4 days for children treated with antibiotic-glucocorticoid eardrops versus 5 days for those treated with oral antibiotics (P<0.001) and 12 days for those who were assigned to initial observation (P<0.001). Treatment-related adverse events were mild, and no complications of otitis media, including local cellulitis, perichondritis, mastoiditis, and intracranial complications, were reported at 2 weeks.Antibiotic-glucocorticoid eardrops were more effective than oral antibiotics and initial observation in children with tympanostomy tubes who had uncomplicated acute otorrhea. (Funded by the Netherlands Organization for Health Research and Development; Netherlands Trial Register number, NTR1481.).CONCLUSIONSAntibiotic-glucocorticoid eardrops were more effective than oral antibiotics and initial observation in children with tympanostomy tubes who had uncomplicated acute otorrhea. (Funded by the Netherlands Organization for Health Research and Development; Netherlands Trial Register number, NTR1481.). Appropriate treatment of acute uncomplicated otorrhea in children with tympanostomy tubes is unclear. In this trial involving 230 children in the Netherlands, antibiotic–glucocorticoid eardrops were superior to oral amoxicillin–clavulanate or initial observation. The insertion of tympanostomy tubes is one of the most frequently performed surgical procedures in children. 1 The main indications for this procedure are the restoration of hearing in children with persistent otitis media with effusion and the prevention of recurrences in children who have recurrent acute otitis media. 2 Acute otorrhea is a common sequela in children with tympanostomy tubes, with reported incidence rates ranging from 26% in a meta-analysis of mainly observational studies (involving cases of clinically manifested otorrhea) to 75% in a randomized trial (which included asymptomatic and subclinical cases). 3 – 5 Acute tympanostomy-tube otorrhea may be accompanied by foul . . . |
| Author | Venekamp, Roderick P Schilder, Anne G.M van Dongen, Thijs M.A van der Heijden, Geert J.M.G Rovers, Maroeska M |
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| Cites_doi | 10.1016/j.jclinepi.2010.03.004 10.1016/j.jclinepi.2010.02.005 10.1001/archotol.126.5.585 10.1128/CMR.00013-11 10.1056/NEJMoa1007174 10.1542/peds.111.5.1061 10.1001/archotol.1997.01900100019002 10.1542/peds.107.6.1251 10.1136/jech.2003.012914 10.1002/acr.20637 10.1097/INF.0b013e318258f100 10.1002/lary.21015 10.1542/peds.2005-2033 10.1097/00005537-200312000-00011 10.1371/journal.pone.0069062 10.1016/S0140-6736(06)69606-2 10.5694/mja11.10364 10.1016/j.otohns.2003.12.009 10.2165/00003495-200363030-00005 10.1067/mhn.2001.113941 10.1016/S0165-5876(98)00150-5 10.1542/peds.2006-0826 10.1016/j.jclinepi.2006.01.014 |
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| References | Hullmann, SE, Ryan, JL, Ramsey, RR, Chaney, JM, Mullins, LL (r016) 2011; 63 van Dongen, TM, van der Heijden, GJ, Freling, HG, Venekamp, RP, Schilder, AG (r004) 2013; 8 r001 Kay, DJ, Nelson, M, Rosenfeld, RM (r003) 2001; 124 Balkany, TJ, Barkin, RM, Suzuki, BH, Watson, WJ (r023) 1983; 4 Easton, J, Noble, S, Perry, CM (r026) 2003; 63 r018 Scott, IA, Glasziou, PP (r028) 2012; 196 Dohar, J, Giles, W, Roland, P (r009) 2006; 118 Moher, D, Hopewell, S, Schulz, KF (r022) 2010; 63 van Dongen, TM, Schilder, AG, Manders, LA, van der Veen, EL, van der Heijden, GJ (r029) 2012; 31 Heslop, A, Lildholdt, T, Gammelgaard, N, Ovesen, T (r010) 2010; 120 Raat, H, Botterweck, AM, Landgraf, JM, Hoogeveen, WC, Essink-Bot, ML (r015) 2005; 59 Goldblatt, EL, Dohar, J, Nozza, RJ (r011) 1998; 46 Donders, AR, van der Heijden, GJ, Stijnen, T, Moons, KG (r019) 2006; 59 Isaacson, G (r014) 2006; 118 Schulz, KF, Altman, DG, Moher, D (r021) 2010; 63 Ruohola, A, Heikkinen, T, Meurman, O, Puhakka, T, Lindblad, N, Ruuskanen, O (r020) 2003; 111 Tahtinen, PA, Laine, MK, Huovinen, P, Jalava, J, Ruuskanen, O, Ruohola, A (r027) 2011; 364 Peters, BM, Jabra-Rizk, MA, O'May, GA, Costerton, JW, Shirtliff, ME (r007) 2012; 25 Rosenfeld, RM, Goldsmith, AJ, Tetlus, L, Balzano, A (r017) 1997; 123 Roland, PS, Anon, JB, Moe, RD (r024) 2003; 113 r002 Ah-Tye, C, Paradise, JL, Colborn, DK (r005) 2001; 107 r025 Rovers, MM, Glasziou, P, Appelman, CL (r013) 2006; 368 Vaile, L, Williamson, T, Waddell, A, Taylor, G (r008) 2006; 2 Weber, PC, Roland, PS, Hannley, M (r012) 2004; 130 Rosenfeld, RM, Bhaya, MH, Bower, CM (r006) 2000; 126 r020 Balkany TJ (r023) 1983; 4 r021 r022 r017 r019 r013 r014 r015 r016 Vaile L (r008) 2006; 2 r010 r011 r012 r006 r028 r007 r029 r009 r024 r003 r004 r026 r005 r027 24973166 - J Pediatr. 2014 Jul;165(1):208. doi: 10.1016/j.jpeds.2014.04.023. 26565050 - Laryngorhinootologie. 2015 Sep;94(9):574-5. doi: 10.1055/s-0035-1552232. 24778413 - Evid Based Med. 2014 Aug;19(4):132. doi: 10.1136/eb-2014-101814. |
| References_xml | – ident: r025 article-title: U.S. National Library of Medicine. Daily Med ( http://dailymed.nlm.nih.gov ). – volume: 123 start-page: 1049 year: 1997 end-page: 1054 ident: r017 article-title: Quality of life for children with otitis media. publication-title: Arch Otolaryngol Head Neck Surg – volume: 63 start-page: S420 year: 2011 end-page: S430 ident: r016 article-title: Measures of general pediatric quality of life: Child Health Questionnaire (CHQ), DISABKIDS Chronic Generic Measure (DCGM), KINDL-R, Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales, and Quality of My Life Questionnaire (QoML). ;:Suppl 11 publication-title: Arthritis Care Res (Hoboken) – volume: 63 start-page: e1 year: 2010 end-page: e37 ident: r022 article-title: CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. publication-title: J Clin Epidemiol ;[Erratum, J Clin Epidemiol 2012;65:351.] – volume: 118 start-page: e561 year: 2006 end-page: e569 ident: r009 article-title: Topical ciprofloxacin/dexamethasone superior to oral amoxicillin/clavulanic acid in acute otitis media with otorrhea through tympanostomy tubes. publication-title: Pediatrics – volume: 4 start-page: 288 year: 1983 end-page: 291 ident: r023 article-title: A prospective study of infection following tympanostomy and tube insertion. publication-title: Am J Otol – ident: r018 article-title: (http://www.drugepi.org/dope-downloads/-Episheet) – ident: r001 article-title: Cullen K, Hall M, Golosinskiy A. Ambulatory surgery in the United States, 2006. National health statistics reports, no. 11, revised. Hyattsville, MD: National Center for Health Statistics, 2009. – volume: 368 start-page: 1429 year: 2006 end-page: 1435 ident: r013 article-title: Antibiotics for acute otitis media: a meta-analysis with individual patient data. publication-title: Lancet – volume: 124 start-page: 374 year: 2001 end-page: 380 ident: r003 article-title: Meta-analysis of tympanostomy tube sequelae. publication-title: Otolaryngol Head Neck Surg – volume: 63 start-page: 311 year: 2003 end-page: 340 ident: r026 article-title: Amoxicillin/clavulanic acid: a review of its use in the management of paediatric patients with acute otitis media. publication-title: Drugs – volume: 107 start-page: 1251 year: 2001 end-page: 1258 ident: r005 article-title: Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration. publication-title: Pediatrics – volume: 59 start-page: 75 year: 2005 end-page: 82 ident: r015 article-title: Reliability and validity of the short form of the Child Health Questionnaire for Parents (CHQ-PF28) in large random school based and general population samples. publication-title: J Epidemiol Community Health – ident: r002 article-title: Rosenfeld RM, Bluestone CD. Clinical efficacy of surgical therapy. In: Rosenfeld RM, Bluestone CD, eds. Evidence-based otitis media. 2nd ed. Hamilton, ON, Canada: B.C. Decker, 2003:227-40. – volume: 113 start-page: 2116 year: 2003 end-page: 2122 ident: r024 article-title: Topical ciprofloxacin/dexamethasone is superior to ciprofloxacin alone in pediatric patients with acute otitis media and otorrhea through tympanostomy tubes. publication-title: Laryngoscope – volume: 111 start-page: 1061 year: 2003 end-page: 1067 ident: r020 article-title: Antibiotic treatment of acute otorrhea through tympanostomy tube: randomized double-blind placebo-controlled study with daily follow-up. publication-title: Pediatrics – volume: 8 start-page: e69062 year: 2013 end-page: e69062 ident: r004 article-title: Parent-reported otorrhea in children with tympanostomy tubes: incidence and predictors. publication-title: PLoS One – volume: 63 start-page: 834 year: 2010 end-page: 840 ident: r021 article-title: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. publication-title: J Clin Epidemiol – volume: 46 start-page: 91 year: 1998 end-page: 101 ident: r011 article-title: Topical ofloxacin versus systemic amoxicillin/clavulanate in purulent otorrhea in children with tympanostomy tubes. publication-title: Int J Pediatr Otorhinolaryngol – volume: 364 start-page: 116 year: 2011 end-page: 126 ident: r027 article-title: A placebo-controlled trial of antimicrobial treatment for acute otitis media. publication-title: N Engl J Med – volume: 31 start-page: 868 year: 2012 end-page: 869 ident: r029 article-title: Good agreement between parents and physician in the assessment of ear discharge in children. publication-title: Pediatr Infect Dis J – volume: 196 start-page: 304 year: 2012 end-page: 308 ident: r028 article-title: Improving the effectiveness of clinical medicine: the need for better science. publication-title: Med J Aust – volume: 25 start-page: 193 year: 2012 end-page: 213 ident: r007 article-title: Polymicrobial interactions: impact on pathogenesis and human disease. publication-title: Clin Microbiol Rev – volume: 120 start-page: 2516 year: 2010 end-page: 2520 ident: r010 article-title: Topical ciprofloxacin is superior to topical saline and systemic antibiotics in the treatment of tympanostomy tube otorrhea in children: the results of a randomized clinical trial. publication-title: Laryngoscope – volume: 118 start-page: 1252 year: 2006 end-page: 1253 ident: r014 article-title: Why don't those ear drops work for my patients? publication-title: Pediatrics – volume: 2 start-page: CD001933 year: 2006 end-page: CD001933 ident: r008 article-title: Interventions for ear discharge associated with grommets (ventilation tubes). publication-title: Cochrane Database Syst Rev – volume: 130 start-page: S89 year: 2004 end-page: S94 ident: r012 article-title: The development of antibiotic resistant organisms with the use of ototopical medications. ;:Suppl publication-title: Otolaryngol Head Neck Surg – volume: 59 start-page: 1087 year: 2006 end-page: 1091 ident: r019 article-title: A gentle introduction to imputation of missing values. publication-title: J Clin Epidemiol – volume: 126 start-page: 585 year: 2000 end-page: 592 ident: r006 article-title: Impact of tympanostomy tubes on child quality of life. publication-title: Arch Otolaryngol Head Neck Surg – volume: 4 start-page: 288 year: 1983 ident: r023 publication-title: Am J Otol – ident: r022 doi: 10.1016/j.jclinepi.2010.03.004 – ident: r021 doi: 10.1016/j.jclinepi.2010.02.005 – ident: r006 doi: 10.1001/archotol.126.5.585 – ident: r007 doi: 10.1128/CMR.00013-11 – ident: r027 doi: 10.1056/NEJMoa1007174 – ident: r020 doi: 10.1542/peds.111.5.1061 – ident: r017 doi: 10.1001/archotol.1997.01900100019002 – ident: r005 doi: 10.1542/peds.107.6.1251 – ident: r015 doi: 10.1136/jech.2003.012914 – ident: r016 doi: 10.1002/acr.20637 – ident: r029 doi: 10.1097/INF.0b013e318258f100 – ident: r010 doi: 10.1002/lary.21015 – ident: r009 doi: 10.1542/peds.2005-2033 – ident: r024 doi: 10.1097/00005537-200312000-00011 – ident: r004 doi: 10.1371/journal.pone.0069062 – ident: r013 doi: 10.1016/S0140-6736(06)69606-2 – ident: r028 doi: 10.5694/mja11.10364 – ident: r012 doi: 10.1016/j.otohns.2003.12.009 – ident: r026 doi: 10.2165/00003495-200363030-00005 – ident: r003 doi: 10.1067/mhn.2001.113941 – ident: r011 doi: 10.1016/S0165-5876(98)00150-5 – ident: r014 doi: 10.1542/peds.2006-0826 – ident: r018 – volume: 2 start-page: CD001933 year: 2006 ident: r008 publication-title: Cochrane Database Syst Rev – ident: r019 doi: 10.1016/j.jclinepi.2006.01.014 – reference: 24973166 - J Pediatr. 2014 Jul;165(1):208. doi: 10.1016/j.jpeds.2014.04.023. – reference: 26565050 - Laryngorhinootologie. 2015 Sep;94(9):574-5. doi: 10.1055/s-0035-1552232. – reference: 24778413 - Evid Based Med. 2014 Aug;19(4):132. doi: 10.1136/eb-2014-101814. |
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| Snippet | Appropriate treatment of acute uncomplicated otorrhea in children with tympanostomy tubes is unclear. In this trial involving 230 children in the Netherlands,... Recent guidance for the management of acute otorrhea in children with tympanostomy tubes is based on limited evidence from trials comparing oral antibiotic... BackgroundRecent guidance for the management of acute otorrhea in children with tympanostomy tubes is based on limited evidence from trials comparing oral... |
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| Title | A Trial of Treatment for Acute Otorrhea in Children with Tympanostomy Tubes |
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