Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Otitis Media With Effusion Medication

  • Author: Thomas S Higgins, Jr, MD, MSPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
 
Updated: Feb 04, 2016
 

Medication Summary

A consensus statement published in August 2000 defined an appropriate logarithm for the medical treatment of acute otitis media (AOM) and recurrent acute otitis media (RAOM).[32] Antimicrobials are the only medications that have been shown to increase the rate of clearance of otitis media with effusion (OME) in randomized controlled trials. However, these benefits are temporary at best.

The 2004 clinical guidelines recommended avoiding the use of antibiotics, decongestants, oral steroids, and antihistamines for the treatment of otitis media with effusion due to evidence that cites their lack of effectiveness.[11, 33] The guidelines did not make a recommendation for or against the use of intranasal steroids, nor were any recommendations made for alternative medicine treatments.

Next

Topical Nasal Steroids

Class Summary

Results of small trials have shown that nasal steroids speed the clearance of otitis media with effusion (OME) and prevent its recurrence. A 2011 meta-analysis confirmed these findings.[20] However, to the author's knowledge, no large randomized trials have been performed to confirm this finding.

Fluticasone (Flonase)

 

Fluticasone is a topical corticosteroid spray that has anti-inflammatory effects on the nasal mucosa and, presumably, on the nasopharynx, where the eustachian tube orifice is located.

Previous
Next

Antibiotics, Otic

Class Summary

An otic suspension may be used intraoperatively.

Ciprofloxacin otic (Otiprio)

 

Ciprofloxacin is an ototopical fluoroquinolone. This class of antimicrobial has a broad spectrum of activity. Additionally, fluoroquinolones do not cause vestibular or cochlear toxicity, recognized with aminoglycosides. The sustained-exposure ciprofloxacin suspension (Otiprio) is indicated for pediatric patients with bilateral otitis media with effusion undergoing tympanostomy tube placement. It is administered as a single intratympanic dose of 0.1 mL (6 mg) into each affected ear, following suctioning of the middle ear effusion.

Previous
 
Contributor Information and Disclosures
Author

Thomas S Higgins, Jr, MD, MSPH Rhinologist and Associate in Otolaryngology-Head and Neck Surgery, Kentuckiana Ear, Nose and Throat, PSC

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Acknowledgements

Gregory C Allen, MD Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Disclosure: Nothing to disclose.

Richard D Thrasher III, MD Private Practice, McKinney, Texas

Richard D Thrasher III, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and American Rhinologic Society

Disclosure: Nothing to disclose.

References
  1. Minovi A, Dazert S. Diseases of the middle ear in childhood. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2014. 13:Doc11. [Medline]. [Full Text].

  2. Bluestone CD, Beery QC, Andrus WS. Mechanics of the eustachian tube as it influences susceptibility to and persistence of middle ear effusions in children. Ann Otol Rhinol Laryngol. 1974 Mar-Apr. 83:Suppl 11:27-34. [Medline].

  3. Crapko M, Kerschner JE, Syring M, Johnston N. Role of extra-esophageal reflux in chronic otitis media with effusion. Laryngoscope. 2007 Jun 20. [Medline].

  4. O'Reilly RC, Soundar S, Tonb D, et al. The Role of Gastric Pepsin in the Inflammatory Cascade of Pediatric Otitis Media. JAMA Otolaryngol Head Neck Surg. 2015 Jan 29. [Medline].

  5. Yilmaz T, Koçan EG, Besler HT, Yilmaz G, Gürsel B. The role of oxidants and antioxidants in otitis media with effusion in children. Otolaryngol Head Neck Surg. 2004 Dec. 131(6):797-803. [Medline].

  6. Harman NL, Bruce IA, Callery P, Tierney S, Sharif MO, O Brien K, et al. MOMENT -- Management of Otitis Media with Effusion in Cleft Palate: protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey. Trials. 2013 Mar 12. 14(1):70. [Medline].

  7. Kubba H, Pearson JP, Birchall JP. The aetiology of otitis media with effusion: a review. Clin Otolaryngol. 2000 Jun. 25(3):181-94. [Medline].

  8. Siddartha, Bhat V, Bhandary SK, Shenoy V, Rashmi. Otitis media with effusion in relation to socio economic status: a community based study. Indian J Otolaryngol Head Neck Surg. 2012 Mar. 64(1):56-8. [Medline]. [Full Text].

  9. Erdivanli OC, Coskun ZO, Kazikdas KC, Demirci M. Prevalence of Otitis Media with Effusion among Primary School Children in Eastern Black Sea, in Turkey and the Effect of Smoking in the Development of Otitis Media with Effusion. Indian J Otolaryngol Head Neck Surg. 2012 Mar. 64(1):17-21. [Medline]. [Full Text].

  10. Choi HG, Sim S, Kim SY, Lee HJ. A high-fat diet is associated with otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2015 Dec. 79 (12):2327-31. [Medline].

  11. [Guideline] Rosenfeld RM, Culpepper L, Doyle KJ, Grundfast KM, Hoberman A, Kenna MA. Clinical practice guideline: Otitis media with effusion. Otolaryngol Head Neck Surg. 2004 May. 130(5 Suppl):S95-118. [Medline].

  12. Pichichero ME, Poole MD. Assessing diagnostic accuracy and tympanocentesis skills in the management of otitis media. Arch Pediatr Adolesc Med. 2001 Oct. 155(10):1137-42. [Medline].

  13. Kaleida PH. Evidence assessment of the accuracy of methods of diagnosing middle ear effusion in children with otitis media with effusion. J Pediatr. 2004 Jul. 145(1):138. [Medline].

  14. [Guideline] Frellick M. Otitis Media: New Guideline Includes Screening At-Risk Kids. Medscape Medical News. 2016 Feb 4. [Full Text].

  15. [Guideline] Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016 Feb. 154 (1 Suppl):S1-S41. [Medline]. [Full Text].

  16. Williamson I, Vennik J, Harnden A, et al. Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial. CMAJ. 2015 Sep 22. 187 (13):961-9. [Medline]. [Full Text].

  17. Kouwen HB, Dejonckere PH. Prevalence of OME is reduced in young children using chewing gum. Ear Hear. 2007 Aug. 28(4):451-5. [Medline].

  18. Williams RL, Chalmers TC, Stange KC, et al. Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion. A meta-analytic attempt to resolve the brouhaha. JAMA. 1993 Sep 15. 270(11):1344-51. [Medline].

  19. Tracy JM, Demain JG, Hoffman KM, Goetz DW. Intranasal beclomethasone as an adjunct to treatment of chronic middle ear effusion. Ann Allergy Asthma Immunol. 1998 Feb. 80(2):198-206. [Medline].

  20. Simpson SA, Lewis R, van der Voort J, Butler CC. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2011 May 11. CD001935. [Medline].

  21. Simpson SA, Lewis R, van der Voort J, Butler CC. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2011 May 11. 5:CD001935. [Medline].

  22. Williamson I, Benge S, Barton S, et al. A double-blind randomised placebo-controlled trial of topical intranasal corticosteroids in 4- to 11-year-old children with persistent bilateral otitis media with effusion in primary care. Health Technol Assess. 2009 Aug. 13(37):1-144. [Medline].

  23. Cantekin EI, Mandel EM, Bluestone CD, et al. Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial. N Engl J Med. 1983 Feb 10. 308(6):297-301. [Medline].

  24. Griffin G, Flynn CA. Antihistamines and/or decongestants for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2011 Sep 7. 9:CD003423. [Medline].

  25. Maw R, Bawden R. Spontaneous resolution of severe chronic glue ear in children and the effect of adenoidectomy, tonsillectomy, and insertion of ventilation tubes (grommets). BMJ. 1993 Mar 20. 306(6880):756-60. [Medline].

  26. Boston M, McCook J, Burke B, Derkay C. Incidence of and risk factors for additional tympanostomy tube insertion in children. Arch Otolaryngol Head Neck Surg. 2003 Mar. 129(3):293-6. [Medline].

  27. Burton MJ, Rosenfeld RM. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Otolaryngol Head Neck Surg. 2006 Oct. 135(4):507-10. [Medline].

  28. Barclay L. Postop Tympanostomy Tube Obstruction Common. Medscape Medical News. Jul 11 2014. [Full Text].

  29. Conrad DE, Levi JR, Theroux ZA, et al. Risk Factors Associated With Postoperative Tympanostomy Tube Obstruction. JAMA Otolaryngol Head Neck Surg. 2014 Jul 10. [Medline].

  30. Mair EA, Moss JR, Dohar JE, Antonelli PJ, Bear M, LeBel C. Randomized Clinical Trial of a Sustained-Exposure Ciprofloxacin for Intratympanic Injection During Tympanostomy Tube Surgery. Ann Otol Rhinol Laryngol. 2015 Aug 20. [Medline].

  31. Brooks M. FDA OKs Otiprio for kids getting tympanostomy tube placement. Medscape Medical News. Dec 14, 2015. [Full Text].

  32. Pichichero ME, Reiner SA, Brook I, et al. Controversies in the medical management of persistent and recurrent acute otitis media. Recommendations of a clinical advisory committee. Ann Otol Rhinol Laryngol Suppl. 2000 Aug. 183:1-12. [Medline].

  33. [Guideline] Rosenfeld RM, Culpepper L, Doyle KJ. Clinical practice guideline: Otitis media with effusion. Am Fam Physician. 2004 Jun 15. 69(12):2776, 2778-9. [Medline]. [Full Text].

Previous
Next
 
Anatomy of the external and middle ear.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.