Clinical effects of clarithromycin on persistent inflammation following Haemophilus influenzae-positive acute otitis media

Abstract

Conclusion: Additional treatment with clarithromycin (CAM) reduced persistent middle ear inflammation after acute otitis media (AOM) caused by Haemophilus influenzae in children. CAM is a treatment option for persistent inflammation following AOM and to prevent continuing otitis media with effusion. Objective: We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children. Methods: H. influenzae-infected children with AOM were treated acutely with antimicrobial agents, after which those still demonstrating effusion of the middle ear cavity received additional treatment with carbocysteine (S-CMC) alone or S-CMC combined with clarithromycin (CAM) for 1 week. The two regimens were compared in terms of clinical effects. Results: After the initial acute treatment, many patients still showed abnormal otoscopic findings. At the completion of additional treatment, there were no significant differences between the two treatment groups. However, 1 week after completion of additional treatment, the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group (p = 0.017). The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug (p = 0.097).

Keywords:

• Biofilm
• cell invasion
• clinical effects

Acknowledgement

Taisho Toyama Pharmaceutical Company was the funding source for bacteriological examination of middle ear effusions and nasopharyngeal smears, and was involved in the study conduct and analysis.

Declaration of interest: The corresponding author declares having grants from Taisho Toyama Pharmaceutical Company for conducting the study. The authors alone are responsible for the content and writing of the paper.