Treating Recurrent Otitis Media: An Expert's View
Treating Recurrent Otitis Media: An Expert's View
One of the problems with recurrent otitis media is that it has issues with responding to any treatment that we give. Traditionally, people tried to give antibiotics, either acute antibiotics or prophylactic antibiotics. They also tried steroids, antihistamines, and now probiotics and prebiotics, although none of those have been proven to reduce otitis media in the long run when used for just a few days after treatment.
We understand now that for biofilms, we have some antibiotics, such as the long-acting macrolides, that may treat it appropriately or even prevent it. Part of what we understand about respiratory disease in general includes the effect of macrolides on lower respiratory tracts. We have some fragments of evidence from experimental otitis and from treating children that maybe the macrolides can treat or even prevent some of the recurrent cases. But it is very fragmented at the moment. We do not know too much yet; this needs more study.
The introduction of tympanostomy tubes has helped some children, but not others. Prophylactic antibiotics may help some children, but then prophylactic antibiotics, of course, lead to resistance. Altogether, we are quite frustrated with treatment at the moment, and we don't have too much news to give you about it.
Treatments for Recurrent Otitis Media
One of the problems with recurrent otitis media is that it has issues with responding to any treatment that we give. Traditionally, people tried to give antibiotics, either acute antibiotics or prophylactic antibiotics. They also tried steroids, antihistamines, and now probiotics and prebiotics, although none of those have been proven to reduce otitis media in the long run when used for just a few days after treatment.
We understand now that for biofilms, we have some antibiotics, such as the long-acting macrolides, that may treat it appropriately or even prevent it. Part of what we understand about respiratory disease in general includes the effect of macrolides on lower respiratory tracts. We have some fragments of evidence from experimental otitis and from treating children that maybe the macrolides can treat or even prevent some of the recurrent cases. But it is very fragmented at the moment. We do not know too much yet; this needs more study.
The introduction of tympanostomy tubes has helped some children, but not others. Prophylactic antibiotics may help some children, but then prophylactic antibiotics, of course, lead to resistance. Altogether, we are quite frustrated with treatment at the moment, and we don't have too much news to give you about it.
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