Abstract
To evaluate the outcome of otitis media(OM), we followed 93 children with OM and middle ear effusion(MEE) identified by tympanocentesis. Bacterial pathogens were isolated from the MEE in 63 children: S. pneumoniae(33), H. influenzae(22), S. pyogenes(1), N. meningitidis(1), H.catarrhalis(3), or mixed pathogens(3). Thirty-five were treated with ampicillin(AMP), 58 with trimetho-prim-sulfamethoxazole(TMP-SMZ) and all with pseudoephedrine.
Middle ear effusion persisting for 4 weeks or longer after presentation (PMEE) occurred in 37.5% of the 93 patients. PMEE was found in 49% of 57 children 2-24 months old and 19% of 36 children 25-144 months old(p < .01). 28.5% of 63 children with bacterial pathogens in initial MEE cultures and 56.5% of 30 with negative cultures had PMEE(p < .01). This relationship was seen in all age groups. No association was observed between PMEE and history of prior middle ear infection, sex, or choice of antimicrobial agent.
3 of 35 AMP and 2 of 58 TMP-SMZ treated patients had persistence of the infecting organism in MEE documented 6-28 days after onset. A new infection occurred during follow-up in 2 AMP and 3 TMP-SMZ treated children. There was no difference in incidence of PMEE between children with bacterial pathogens in MEE(5 of 10) and those with sterile MEE (15 of 29) at follow-up.
Identification of children at risk for persistent effusion is important if morbidity of chronic middle ear disease is to be reduced. Children ≤ 24 months old and those with sterile MEE appear to have a significant incidence of PMEE.
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Pelton, S., Shurin, P. & Klein, J. PERSISTENCE OF MIDDLE EAR EFFUSION AFTER OTITIS MEDIA. Pediatr Res 11, 504 (1977). https://doi.org/10.1203/00006450-197704000-00803
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DOI: https://doi.org/10.1203/00006450-197704000-00803