Disappearance of middle ear effusion in acute otitis media monitored daily with tympanometry.
BACKGROUND
Disappearance of middle ear effusion is one of the most important outcomes in the treatment of acute otitis media (AOM).


OBJECTIVE
To evaluate the duration of effusion in AOM treated by antimicrobials and to find factors influencing it.


METHODS
Parents of 90 children with AOM monitored daily the disappearance of effusion with tympanometry. The children were randomly allocated to be treated with either oral amoxicillin or cefuroxime-axetil for 10 d. Daily monitoring lasted for 14 d or until the tympanogram was normal (curve A or C) in both ears. Pneumatic otoscopy was carried out every 2 wk.


RESULTS
Normal tympanograms were obtained after a median time of 7.5 d (range 1-58 d) among 75 successfully monitored patients. In two-thirds (69%) of them, effusion resolved in 14 d. The median duration of effusion did not differ significantly between the two treatment groups (8 vs 7 days, p=0.7). The children who had unilateral AOM cured more rapidly than those with bilateral AOM (5 vs 19 d, p<0.001). In logistic regression analysis adjusted for age, bilaterality explained treatment failure at 2 wk with an odds ratio of 28.1 (95% CI 4.6-169.5, p<0.001).


CONCLUSIONS
The choice of antimicrobials did not influence the duration of middle ear effusion, which was much shorter than had been thought previously. Children with unilateral AOM were cured much more quickly than those with bilateral AOM.
Department of Paediatrics, University of Oulu, Oulu, Finland. marjo.renko@oulu.fi
Marjo
M
Renko
Tero
T
Kontiokari
Katariina
K
Jounio-Ervasti
Heikki
H
Rantala
Matti
M
Uhari
D000158:Acoustic Impedance Tests; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002444:Cefuroxime / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D002444:Cefuroxime; C040738:cefuroxime axetil