Monday 01 October 2007, 12:00AM
PEARLS 30, October 2007, written by Brian R
McAvoy
Clinical question
Are antihistamines, decongestants or combination therapy effective
in children with otitis media with effusion (OME)?
Bottom line
Antihistamines and/or decongestants do not help and may harm when
used for symptoms of OME ("glue ear"). There was no benefit for any
of the short or long term outcomes including resolution of the
fluid, hearing problems or the necessity of additional referral to
specialists.
Caveat
These medications caused significant side effects, such
as gastrointestinal upset, irritability, drowsiness or dizziness in
approximately 10 per cent of the children studied.
Context
OME is a common condition in which there is fluid persisting in
the middle ear. Many treatments have been suggested. Watchful
waiting is the best approach,with consideration of referral for
evaluation by an ear nose and throat consultant if symptoms persist
beyond 12 weeks.
Cochrane Systematic Review
Griffin GH, Flynn C, Bailey RE, Schultz JK.
Antihistamines and/or decongestants for otitis media with effusion
(OME) in children. Cochrane Database of Systematic Reviews 2006,
Issue 4. Article No. CD003423. DOI: 10.1002/14651858.CD003423.pub2.
Note: This review contains 16 trials involving 1737
participants.