Oral prednisolone is an effective adjuvant therapy for acute otitis media with discharge through tympanostomy tubes

Objective: To determine the efficacy of a short course of oral prednisolone as an adjuvant therapy for acute otitis media draining through tympanostomy tubes. Study design: In a randomized, double-blind, placebo-controlled study, children with acute discharge (<48 hours) through tympanostomy tubes received either prednisolone (2 mg/kg/d; n = 23) or placebo (n = 27) for 3 days. AU children received amoxicillin/clavulanate (40/10 mg/kg/d) for 7 days. The children were examined daily at the study clinic until the drainage ceased. Results: The median duration of otorrhea in the prednisolone group was 1.0 days (25% to 75% range, 1.0 to 2.0 days), compared with 3.0 days (25% to 75% range, 2.0 to 4.0 days) in the children receiving placebo (P < .001). The duration of otorrhea was less than or equal to 2 days in 21 (91%) children in the prednisolone group, compared with 8 (30%) children in the placebo group (P < .001). Conclusions: Oral prednisolone appears to be modestly effective adjuvant therapy for acute otitis media with discharge through tympanostomy tubes in children. Further studies seem warranted to determine whether shortterm use of steroids early during the course of acute otitis media would also reduce the duration of middle ear effusion in children with intact tympanic membranes.