MANAGEMENT OF CHRONIC MIDDLE-EAR EFFUSION WITH PREDNISONE COMBINED WITH TRIMETHOPRIM-SULFAMETHOXAZOLE

被引:39
作者
BERMAN, S [1 ]
GROSE, K [1 ]
NUSS, R [1 ]
HUBERNAVIN, C [1 ]
ROARK, R [1 ]
GABBARD, SA [1 ]
BAGNALL, T [1 ]
机构
[1] UNIV COLORADO,HLTH SCI CTR,DEPT OTOLARYNGOL,DENVER,CO 80262
关键词
Middle ear effusion; prednisone; TMP/SMZ;
D O I
10.1097/00006454-199008000-00001
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Fifty-three patients were enrolled and evaluable in a randomized, double-blinded controlled clinical trial comparing prednisone for 7 days plus trimethoprim-sulfamethoxazole (TMP/SMZ) for 30 days. TMP/SMZ alone in treating chronic middle ear effusion (MEE).Clearing of the effusion in both ears or in one when only onewas involved wascalled complete resolution; clearing in one of two effected ears wascalled partial resolution. The outcomes 2 weeks after initiation of therapy of 26 patients initially treated with prednisone plus TMP/SMZ were complete resolution in 20, partial resolution inthree, and unchanged in three. The outcomes in 27 patients initially treated with TMP/SMZ alone were complete resolution in eight, partial resolution in three, unchangedin 13 and development of acute otitis media in three<0.01 for complete resolution).Twoweeks after initiation of therapy, patients witha MEE that failed to clear were crossed over to the alternative regimen. Overall 29of 41 patients (71w) who received oral prednisone plus TMP/SMZ initially or after the crossover had complete resolution of their middle ear effusion at 2 weeks afterstarting prednisone and TMP/SMZ. Fiveof 35(%) patients treated with prednisoneplus TMP/SMZ and one of six (17%)patients treated with TMP/SMZ alone whohad complete resolution at 4 weeks requiredsubsequent referrals for tympanostomy tubes.A course of prednisone for 7 days plus TMP/SMZ for 30 days with monthly follow-up should be considered in children with MEE persisting beyond 6ߝ8 weeks before referral for tympanostomy tube placement. © 1990 by Williams & Wilkins.
引用
收藏
页码:533 / 538
页数:6
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