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Acute otitis media in children with tympanostomy tubes.
Can Fam Physician 2008; 54(8):1123-7CF

Abstract

OBJECTIVE

To review evidence regarding antibiotic treatment of acute otitis media in children with tympanostomy tubes and to discuss antibiotic resistance and ototoxicity.

QUALITY OF EVIDENCE

MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched for relevant articles. Articles providing level I evidence(randomized controlled trials) for treatment were used. Key words used in the search included otitis media(MeSH), middle ear ventilation (MeSH), tympanostomy tubes, and otorrhea.

MAIN MESSAGE

Tympanostomy tube insertion is a common procedure; acute otitis media is a frequent sequela. Treatment options include systemic or topical antibiotics with or without corticosteroids. The development of bacterial resistance to antibiotics and ototoxicity related to treatment are important considerations. There have been well-conducted randomized controlled trials of topical versus systemic antibiotic agents. Combined with proper ear cleaning and tragal pumping, topical fluoroquinolone agents offer the most effective treatment.

CONCLUSION

Current evidence suggests that a topical fluoroquinolone, with or without a corticosteroid, is the treatment of choice for acute otitis media with tympanostomy tubes.

Authors+Show Affiliations

Department of Family Medicine, Queen's University, Kingston, ON, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18697973

Citation

Schmelzle, Jason, et al. "Acute Otitis Media in Children With Tympanostomy Tubes." Canadian Family Physician Medecin De Famille Canadien, vol. 54, no. 8, 2008, pp. 1123-7.
Schmelzle J, Birtwhistle RV, Tan AK. Acute otitis media in children with tympanostomy tubes. Can Fam Physician. 2008;54(8):1123-7.
Schmelzle, J., Birtwhistle, R. V., & Tan, A. K. (2008). Acute otitis media in children with tympanostomy tubes. Canadian Family Physician Medecin De Famille Canadien, 54(8), pp. 1123-7.
Schmelzle J, Birtwhistle RV, Tan AK. Acute Otitis Media in Children With Tympanostomy Tubes. Can Fam Physician. 2008;54(8):1123-7. PubMed PMID: 18697973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute otitis media in children with tympanostomy tubes. AU - Schmelzle,Jason, AU - Birtwhistle,Richard V, AU - Tan,Andre K W, PY - 2008/8/14/pubmed PY - 2008/11/5/medline PY - 2008/8/14/entrez SP - 1123 EP - 7 JF - Canadian family physician Medecin de famille canadien JO - Can Fam Physician VL - 54 IS - 8 N2 - OBJECTIVE: To review evidence regarding antibiotic treatment of acute otitis media in children with tympanostomy tubes and to discuss antibiotic resistance and ototoxicity. QUALITY OF EVIDENCE: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched for relevant articles. Articles providing level I evidence(randomized controlled trials) for treatment were used. Key words used in the search included otitis media(MeSH), middle ear ventilation (MeSH), tympanostomy tubes, and otorrhea. MAIN MESSAGE: Tympanostomy tube insertion is a common procedure; acute otitis media is a frequent sequela. Treatment options include systemic or topical antibiotics with or without corticosteroids. The development of bacterial resistance to antibiotics and ototoxicity related to treatment are important considerations. There have been well-conducted randomized controlled trials of topical versus systemic antibiotic agents. Combined with proper ear cleaning and tragal pumping, topical fluoroquinolone agents offer the most effective treatment. CONCLUSION: Current evidence suggests that a topical fluoroquinolone, with or without a corticosteroid, is the treatment of choice for acute otitis media with tympanostomy tubes. SN - 1715-5258 UR - https://www.unboundmedicine.com/medline/citation/18697973/Acute_otitis_media_in_children_with_tympanostomy_tubes_ L2 - http://www.cfp.ca/cgi/pmidlookup?view=long&pmid=18697973 DB - PRIME DP - Unbound Medicine ER -