TREATMENT OF ACUTE OTITIS MEDIA IN CHILDREN (SYSTEMIC ANTIBIOTIC AND TOPICAL NASAL DECONGESTANT VERSUS SYSTEMIC ANTIBIOTIC ALONE)

Background: decongestants whether systemic or topical nasal are widely used in the treatment of acute otitis media but there is still controversy about their effectiveness. The aim of this study is to evaluate the effectiveness of topical nasal decongestants in the treatment of acute otitis media and their role in the resolution of middle ear effusion after acute otitis media attack. Subject and Methods: The current study involved 100 children ranging from 4-12 years of both sexes with acute otitis media that need antibiotics in treatment and the study done in Rizgary teaching hospital in Erbil during the period of 2015-2017. Patients subsequently divided into two groups for treatment. Group A treated with oral co-amoxiclav, oral paracetamol, and topical nasal xylometazoline drop. Group B treated with the same antibiotic but without topical nasal xylometazoline drop. The children are followed up three months by 5 visits; in the first and second follow up visits the children are examined clinically for the improvement in the signs and symptoms of acute infection. In the last three visits the children are followed up for the resolution of middle ear effusion by otoscopic examination and tympanometry test. Pure Tone Audiometry (PTA) test done for children in the first and fifth visits, to know the hearing gain between the two visits and the difference between group A and group B. Results: The mean age + SD of the children were 7.26 + 2.4 years, ranging from 4 to 12 years. The median was 7 years. 58% of the patients were boys and 42% were girls. In the first visit, we found better results in group A that was near significant for pain relief (p=0.067). During subsequent visits we found good resolution in both groups with non significant better results in group A. Conclusions: there is no significant benefit from the use of topical nasal decongestant in the treatment of AOM. Duhok Med J 2018; 12 (1): 96-105