title: Adenoidectomy versus chemoprophylaxis and placebo for recurrent acute otitis media in children aged under 2 years: randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy of adenoidectomy compared with long term chemoprophylaxis and placebo in the prevention of recurrent acute otitis media in children aged between 10 months and 2 years.
  
  
  METHODS
  Randomised, double blind, controlled trial.
  
  
  METHODS
  Oulu University Hospital, a tertiary centre in Finland.
  
  
  METHODS
  180 children aged 10 months to 2 years with recurrent acute otitis media.
  
  
  METHODS
  Adenoidectomy, sulfafurazole (sulphisoxazole) 50 mg/kg body weight, given once a day for six months or placebo. Follow up lasted for two years, during which time all symptoms and episodes of acute otitis media were recorded.
  
  
  METHODS
  Intervention failure (two episodes in two months or three in six months or persistent effusion) during follow up, number of episodes of acute otitis media, number of visits to a doctor because of any infection, and antibiotic prescriptions Number of prescriptions, and days with symptoms of respiratory infection.
  
  
  RESULTS
  Compared with placebo, interventions failed during both the first six months and the rest of the follow up period of 24 months similarly in the adenoidectomy and chemoprophylaxis groups (at six months the differences in risk were 10% (95% confidence interval -9% to 29%) and 18% (-2% to 38%), respectively). No significant differences were observed between the groups in the numbers of episodes of acute otitis media, visits to a doctor, antibiotic prescriptions, and days with symptoms of respiratory infection.
  
  
  CONCLUSIONS
  Adenoidectomy, as the first surgical treatment of children aged 10 to 24 months with recurrent acute otitis media, is not effective in preventing further episodes. It cannot be recommended as the primary method of prophylaxis.
authors.affiliation: University of Oulu, PO Box 5000, FIN-90014, Finland. petri.koivunen@ppshp.fi
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
authors.forename: Matti
authors.initials: M
authors.lastname: Uhari
authors.forename: Jukka
authors.initials: J
authors.lastname: Luotonen
authors.forename: Aila
authors.initials: A
authors.lastname: Kristo
authors.forename: Risto
authors.initials: R
authors.lastname: Raski
authors.forename: Tytti
authors.initials: T
authors.lastname: Pokka
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Alho
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods; D010033:Otitis Media / Q000517:prevention & control* / Q000601:surgery; D012008:Recurrence; D013444:Sulfisoxazole / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000890:Anti-Infective Agents; D013444:Sulfisoxazole