Clinical effects of clarithromycin on persistent inflammation following Haemophilus influenzae-positive acute otitis media

Acta Otolaryngol. 2015 Mar;135(3):217-25. doi: 10.3109/00016489.2014.975893.

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.

Objective: We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children.

Methods: 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.

Results: 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).

Keywords: Biofilm; cell invasion; clinical effects.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents, Local / therapeutic use
  • Carbocysteine / therapeutic use
  • Child
  • Child, Preschool
  • Clarithromycin / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Haemophilus Infections / drug therapy*
  • Haemophilus influenzae*
  • Humans
  • Infant
  • Male
  • Otitis Media / drug therapy*
  • Otitis Media / microbiology
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Carbocysteine
  • Clarithromycin