Occurrence of otitis media in children and assessment of treatment options

Nwokoye, Nkiru N.; Egwari, L. O.; Olubi, Olawale

doi:10.1017/s0022215115001127

Cited by 18 publications

(14 citation statements)

References 19 publications

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“…From these, 32 articles were also excluded as the outcome of interest was missing, insufficient and/or ambiguous, and 2 articles were not accessible in full text [22,23]. Fifty-two studies were evaluated by a full-text review and 16 studies had data collection period before 2009 and three studies [24][25][26] have no record of the data collection period. Finally, 33 articles passed the eligibility criteria and quality assessment and hence included in the study (Fig.…”

Section: Search Resultsmentioning

confidence: 99%

Bacterial otitis media in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2020

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Background: Otitis media is inflammation of the middle ear, comprising a spectrum of diseases. It is the commonest episode of infection in children, which often occurs after an acute upper respiratory tract infection. Otitis media is ranked as the second most important cause of hearing loss and the fifth global burden of disease with a higher incidence in developing worlds like Sub-Saharan Africa and South Asia. Therefore, this systematic review is aimed to quantitatively estimate the current status of bacterial otitis media, bacterial etiology and their susceptibility profile in sub-Saharan Africa. Methods: A literature search was conducted from major databases and indexing services including EMBASE (Ovid interface), PubMed/MEDLINE, Google Scholar, ScienceDirect, Cochrane Library, WHO African Index-Medicus and others. All studies (published and unpublished) addressing the prevalence of otitis media and clinical isolates conducted in sub-Saharan Africa were included. Format prepared in Microsoft Excel was used to extract the data and data was exported to Stata version 15 software for the analyses. Der-Simonian-Laird random-effects model at a 95% confidence level was used for pooled estimation of outcomes. The degree of heterogeneity was presented with I 2 statistics. Publication bias was presented with funnel plots of standard error supplemented by Begg's and Egger's tests. The study protocol is registered on PROSPERO with reference number ID: CRD42018102485 and the published methodology is available from http://www.crd.york.ac.uk/CRD42018102485. Results: A total of 33 studies with 6034 patients were included in this study. All studies have collected ear swab/ discharge samples for bacterial isolation. The pooled isolation rate of bacterial agents from the CSOM subgroup was 98%, patients with otitis media subgroup 87% and pediatric otitis media 86%. A univariate meta-regression analysis indicated the type of otitis media was a possible source of heterogeneity (p-value = 0.001). The commonest isolates were P. aeruginosa (23-25%), S. aureus (18-27%), Proteus species (11-19%) and Klebsiella species. High level of resistance was observed against Ampicillin, Amoxicillin-clavulanate, Cotrimoxazole, Amoxicillin, and Cefuroxime. Conclusion: The analysis revealed that bacterial pathogens like P. aeruginosa and S. aureus are majorly responsible for otitis media in sub-Saharan Africa. The isolates have a high level of resistance to commonly used drugs for the management of otitis media.

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Section: Search Resultsmentioning

confidence: 99%

Bacterial otitis media in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2020

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“…Children aged less than six months are considered high risk because recurring bouts of otitis media may predispose them to complications that include speech difficulties and hearing loss. 1,2 In our study, we reported the highest incidences of non-resolving acute otitis media following initial paracetamol usage in children aged 7-12 months (43.5 per cent) and 2-5 years (42.1 per cent). 3 In chronic suppurative otitis media (CSOM) where microbial aetiology is implicated, it is important that antibiotics be given.…”

Section: Authors' Replymentioning

confidence: 52%

“…Dear Editors, I came across a very interesting article published in your esteemed journal titled 'Occurrence of otitis media in children and assessment of treatment options' by Nwokoye et al 1 The study had been well planned and was very thought provoking. However, I beg to differ from the author's conclusion and would like to highlight the same through your esteemed journal.…”

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confidence: 99%

Occurrence of otitis media in children and assessment of treatment options

Bakshi

2015

J. Laryngol. Otol.

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“…Recurrent AOM can develop into chronic otitis media, which often requires surgical intervention such as myringotomy and placement of tympanostomy tubes for ventilation and drainage [7][8][9]. Chronic otitis media has also been associated with sensorineural hearing loss, which may lead to speech and learning deficits [9][10][11][12][13]. In the US alone, 500,000 children undergo tympanostomy surgery annually at a cost of $5 billion [14].…”

Section: Incidence and Severity Of Acute Otitis Mediamentioning

confidence: 99%

Controlled release of ciprofloxacin and ceftriaxone from a single ototopical administration of antibiotic-loaded polymer microspheres and thermoresponsive gel

et al. 2020

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Acute otitis media (AOM) is the main indication for pediatric antibiotic prescriptions, accounting for 25% of prescriptions. While the use of topical drops can minimize the administered dose of antibiotic and adverse systemic effects compared to oral antibiotics, their use has limitations, partially due to low patient compliance, high dosing frequency, and difficulty of administration. Lack of proper treatment can lead to development of chronic OM, which may require invasive interventions. Previous studies have shown that gel-based drug delivery to the ear is possible with intratympanic injection or chemical permeation enhancers (CPEs). However, many patients are reluctant to accept invasive treatments and CPEs have demonstrated toxicity to the tympanic membrane (TM). We developed a novel method of delivering therapeutics to the TM and middle ear using a topical, thermoresponsive gel depot containing antibiotic-loaded poly(lactic-co-glycolic acid) microspheres. Our in vitro and ex vivo results suggest that the sustained presentation can safely allow therapeutically relevant drug concentrations to penetrate the TM to the middle ear for up to 14 days. Animal results indicate sufficient antibiotic released for treatment from topical administration 24h after bacterial inoculation. However, animals treated 72h after inoculation, a more clinically relevant treatment practice, displayed spontaneous clearance of infection as is also often observed in the clinic. Despite this variability in the disease model, data suggest the system can safely treat bacterial infection, with future studies necessary to optimize microsphere formulations for scaled up dosage of antibiotic as well as further investigation of the influence of spontaneous bacterial clearance and of biofilm formation on effectiveness of treatment. To our knowledge, this study represents the first truly topical drug delivery system to the middle ear without the use of CPEs.

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Occurrence of otitis media in children and assessment of treatment options

Abstract: The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

Cited by 18 publications

References 19 publications

Bacterial otitis media in sub-Saharan Africa: a systematic review and meta-analysis

Bacterial otitis media in sub-Saharan Africa: a systematic review and meta-analysis

Occurrence of otitis media in children and assessment of treatment options

Controlled release of ciprofloxacin and ceftriaxone from a single ototopical administration of antibiotic-loaded polymer microspheres and thermoresponsive gel

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