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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Bibliographic Details
Published in:The New England journal of medicine Vol. 370; no. 8; pp. 723 - 733
Main Authors: van Dongen, Thijs M.A, van der Heijden, Geert J.M.G, Venekamp, Roderick P, Rovers, Maroeska M, Schilder, Anne G.M
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 20.02.2014
Subjects:
Administration, Oral
Administration, Topical
Amoxicillin
Amoxicillin-Potassium Clavulanate Combination - administration & dosage
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - adverse effects
Antibiotics
Bacitracin
Bacitracin - administration & dosage
Bacterial infections
Biological and medical sciences
Cellulitis
Child
Child, Preschool
Children
Colistin
Colistin - administration & dosage
Drug Combinations
Ear
Ear diseases
Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology
Female
General aspects
Glucocorticoids
Glucocorticoids - administration & dosage
Glucocorticoids - adverse effects
Humans
Hydrocortisone
Hydrocortisone - administration & dosage
Infant
Kaplan-Meier Estimate
Male
Mastoiditis
Medical sciences
Medical treatment
Middle Ear Ventilation - adverse effects
Non tumoral diseases
Otitis media
Otitis Media with Effusion - drug therapy
Otitis Media with Effusion - etiology
Otitis Media with Effusion - surgery
Otorhinolaryngology. Stomatology
Parents & parenting
Perichondritis
Quality of life
Netherlands
Human
Medicine
Treatment
Acute
ENT disease
Child
Otorrhea
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary: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 . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1301630