The role of topical therapy in the treatment of acute otitis media in children
https://doi.org/10.21518/2079-701X-2020-18-48-52
Abstract
Acute otitis media is a common disease in children and accounts for about 2% of the total child morbidity. In the largest percentage of cases, acute otitis is usually successfully resolved, but its relapses increase the possibility of complications and lead to higher treatment costs, as well as lower quality of life for both the patient and his or her family in general. Therapy of acute otitis media depends on the stage of disease development and clinical manifestations and is aimed at early resolution of inflammatory process and prevention of disease progress and complications development. Pathogenetic therapy is shown at the 1st and 2nd stages of development of acute otitis media and is based on restoration of auditory tube function and normalization of nasal breathing (unloading – intranasal therapy). As a local analgesic therapy for acute otitis media in children, ear drops containing non-opioid analgesic antipyretic drug phenazone and lidocaine, consisting of a combination of phenazone (40 mg) and lidocaine hydrochloride (10 mg), are most commonly used. Phenazone is a nonsteroidal anti-inflammatory drug and has an anti-inflammatory effect, typical for non-selective inhibitors of cyclooxygenase, while lidocaine has a local analgesic effect. Based on the clinical trials conducted, it was recommended to include combined topical drugs as a local analgesic and anti-inflammatory drug with effective action and good tolerability in all age groups into the combined therapy of acute preperforative otitis media.
About the Author
I. M. Kirichenko
Federal State Autonomous Educational Institution of Higher Education “Peoples’ Friendship University of Russia”
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Professor of the Department of Otorhinolaryngology of the Medical Institute
6, Miklukho-Maklai St., Moscow, 117198, Russia
References
1. Soldatov I.B. Lectures on otorhinolaryngology. Moscow: Meditsina; 1990. 288 р. (In Russ.) Available at: https://bookree.org/reader?file=480210.
2. Rosenfeld R.M., Bluestone C.D. (eds.). Evidence based otitis media. 2nd ed. Hamilton: B.C. Decker; 2003. 529 p.
3. Lokshina E.E., Zaytseva O.V. Modern approach to the treatment of acute respiratory infections in children. Pediatriya. Consilium Medicum = Pediatrics. Consilium Medicum. 2017;(3):54–58. (In Russ.) Available at: https://cyberleninka.ru/article/n/sovremennyy-podhod-k-terapii-ostryh-respiratornyh-zabolevaniy-u-detey.
4. Cherpillod J. Acute otitis media in children. Int J Gen Med. 2011:4;421–423. doi: 10.2147/IJGM.S10309.
5. Froom J., Culpepper L., Green L.A., de Melker R. A., Grob P., Heeren T., van Balen F. Cross-National Study of Acute Otitis Media: Risk Factors, Severity, and Treatment at Initial Visit. Report from the International Primary Care Network (IPCN) and the Ambulatory Sentinel Practice Network (ASPN). J Am Board Fam Pract. 2001;14(6):406–417. Available at: https://pubmed.ncbi.nlm.nih.gov/11757882/.
6. Howard D.H., McGowan J.E. Jr. Initial and follow-up costs by treatment outcome for children with respiratory infections. Pediatrics. 2004;113(5):1352–1356. doi: 10.1542/peds.113.5.1352.
7. Greenberg D., Bilenko N., Liss Z., Shagan T., Zamir O., Dagan R. The burden of acute otitis media on the patient and the family. Eur J Pediatr. 2003;162(9):576–581. doi: 10.1007/s00431-003-1260-5.
8. Boruk M., Lee P., Faynzilbert Y., Rosenfeld R.M. Caregiver well-being and child quality of life. Otolaryngol Head Neck Surg. 2007;136(2):159–168. doi: 10.1016/j.otohns.2006.09.005.
9. Karneeva O.V., Polyakov D.P., Gurov A.V., Ryazantsev S.V., Maksimova E.A., Kazanova A.V. Approved clinical recommendations of RF on acute middle otitis. Moscow; 2016. (In Russ.) Available at: http://glav-otolar.ru/assets/images/docs/clinical-recomendations/2019/KР314%20Отит%20средний%20острый.pdf.
10. Kosyakov S.Ya., Lopatin A.S. Modern principles of treatment of acute middle, protracted and recurrent acute otitis media. RMZH = RMJ. 2002;(20):1–11. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Sovremennye_principy_lecheniya_ostrogo_srednego_zatyanuvshegosya_i_recidiviruyuschego_ostrogo_srednego_otita.
11. Haggard M: Otitis media: prospects for prevention. Vaccine. 2008;26(Suppl. 7): G20–G24. doi: 10.1016/j.vaccine.2008.11.009.
12. Daly K.A., Hoffman H.J., Kvaerner K.J., Kvestad E., Casselbrant M.L., Homoe P., Rovers M.M. Epidemiology, natural history, and risk factors: panel report from the ninth international research conference on otitis media. Int J Pediatr Otorhinolaryngol. 2010;74(3):231–240. doi: 10.1016/j.ijporl.2009.09.006.
13. Adam D., Federspil P., Lukes M., Petrowicz O. Therapeutic properties and tolerance of procaine and phenazone containing ear drops in infants and very young children. Arzneimittelforschung. 2009;59(10):504–512. doi: 10.1055/s-0031-1296434.
14. Garashchenko T.I., Kirichenko I.M. Mucoregulators in treatment of acute and chronic diseases of the nose and paranasal sinuses, nonsuppurative diseases of the middle ear in children. Voprosy prakticheskoy pediatrii = Clinical Practice in Pediatrics. 2016;11(5):50–55. (In Russ.) doi: 10.20953/1817-7646-2016-5-50-55.
15. Samsygina G.A., Fitilev S.B., Levin A.M. New approaches to the treatment of acute respiratory infections in frequently ill children (results of a multicenter study under the CHIBIS program). Pediatriya = Pediatria. 2006;(1):24–27. Available at: https://cyberleninka.ru/article/n/novye-podhody-k-lecheniyu-ostryh-respiratornyh-infektsiy-u-chasto-boleyuschihdetey-rezultaty-mnogotsentrovogo-issledovaniya-po.
16. Minasyan V.S., Bondarenko M.G. Use of Otipax in acute otitis media in newborns and infants. Bulletin of Otorhinolaryngology = Vestnik Otorinolaringologii. 2004;(4):44. (In Russ.).
17. François M. Efficacy and tolerance of a local application of phenazone and chlorhydrate lidocaine (Otipax) in infants and children with congestive otitis. Ann Pediatr. 1993;40(7):481–484. Available at: https://pubmed.ncbi.nlm.nih.gov/8239401/.
18. Deniz Y., van Uum Rick T., de Hoog M. L. A., Schilder A. G. M., Damoiseaux R. A. M. J., Venekamp R. P. Impact of acute otitis media clinical practice guidelines on antibiotic and analgesic prescriptions: a systematic review. Arch Dis Child. 2018;103(6):597–602. doi: 10.1136/archdischild-2017-314103.
19. Svistushkin V.M., Morozova S.V., Volkova K.B. Rational solution of the problem of local symptomatic treatment in acute otitis media. Meditsinskiy sovet = Medical Council. 2018;(8):42–45. (In Russ.). doi: 10.21518/2079-701X-2018-8-42-45.
20. Thomas J.P., Berner R., Zahnert T., Dazert S. Acute Otitis Media – A Structured Approach. Dtsch Arztebl Int. 2014;111(9):151–159. doi: 10.3238/arztebl.2014.0151.
Review
For citations:
Kirichenko IM. The role of topical therapy in the treatment of acute otitis media in children. Meditsinskiy sovet = Medical Council. 2020;(18):48-52. (In Russ.) https://doi.org/10.21518/2079-701X-2020-18-48-52
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