title: Outcome evaluation of clarithromycin, metronidazole and lansoprazole regimens in Helicobacter pylori positive or negative children with resistant otitis media with effusion.
abstract: OBJECTIVE
  To compare the efficacy of two treatment regimens among Helicobacter pylori stool antigen positive children suffering from resistant otitis media with effusion.
  
  
  METHODS
  The study comprised 258 children with bilateral otitis media with effusion; 134 were positive for H pylori stool antigen, and were equally and randomly allocated to the control group or study group. The control group received standard otitis media with effusion therapy (amoxicillin and clavulanate), while the study group received standard H pylori triple therapy (clarithromycin, metronidazole and lansoprazole).
  
  
  RESULTS
  In the control group, there was a marked clinical response to treatment in 33 of the 67 children (49.3 per cent). In the study group, there was a marked response in a significantly higher number of children (46 out of 67, 68.7 per cent). The 124 H pylori stool antigen negative children not included in the 2 aforementioned groups received amoxicillin and clavulanate, and a marked response in symptoms was evident in 98 of these children (79 per cent).
  
  
  CONCLUSIONS
  H pylori infection may lead to resistance to traditional otitis media with effusion treatment in some cases. H pylori eradication is associated with a high cure rate.
authors.affiliation: Otolaryngology Unit,Faculty of Medicine,Suez Canal University,Ismailia,Egypt.
authors.forename: D
authors.initials: D
authors.lastname: Mel-Hennawi
authors.affiliation: Otolaryngology Unit,Faculty of Medicine,Suez Canal University,Ismailia,Egypt.
authors.forename: M R
authors.initials: MR
authors.lastname: Ahmed
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000302:isolation & purification; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D017291:Clarithromycin / Q000627:therapeutic use*; D019818:Clavulanic Acid / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D064747:Lansoprazole / Q000627:therapeutic use*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D010034:Otitis Media with Effusion / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D008795:Metronidazole; D019818:Clavulanic Acid; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Anti-Bacterial Agents; Bacterial Infections; Campylobacter Pylori; Oral Drug Administration; Otitis Media