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Microbial Nasal Spray Wards Off Recurrent Otitis.

Colonizing the nose with "interfering" [alpha] hemolytic streptococci protects against recurrent otitis media, reported Dr. Kristian Roos of Lundby Hospital, Gothenburg (Sweden), and his associates.

The researchers reasoned that in chil dren who had received many courses of antibiotics to treat recurrent otitis media, the drugs may have diminished the mucosa's normal protective flora. This can inhibit the body's natural defenses and paradoxically raise the risk for more infections.

Nasopharyngeal cultures from children prone to otitis media show low numbers of [alpha]-hemolytic streptococci known to in terfere with the growth of pathogens that cause the disorder (Brit. Med. J. 322[27]:210-12, 2001).

In a 3-year study of 130 children aged 6 months to 6 years with recurrent otitis media, the investigators assessed whether re colonizing the nasopharyngeal mucosa with these protective organisms would prevent reinfection. The children had experienced at least two episodes of acute otitis media during the preceding 6 months or five episodes during the pre ceding year.

Several strains of [alpha]-hemolytic streptococci were isolated from samples obtained from the openings of the eustachian tubes of healthy children. The five strains that showed a superior ability to inhibit the growth of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pyogenes were incorporated into a nasal spray.

The study subjects were treated with antibiotics for their current otitis media infection, then given either the microbial spray or a placebo spray. Parents administered three sprays into each nostril twice a day for 10 days. The children were then clinically evaluated, then given an other 10-day course of the spray after a break of a few weeks, and evaluated a final time.

The recurrence rate of otitis media and secretory otitis media was significantly reduced among the children given the microbial nasal spray: 42% percent of the children had no recurrences over 90 days of follow-up and had normal tympanic membranes at their final evaluation, compared with 22% of the children given the placebo spray.

Secretory otitis media recurred in 31% of children who used the active spray, compared with 56% of those who used the placebo spray. The incidence of side effects was the same in the two study groups.

"The reduction in the number of recurrences after treatment with [[alpha]-hemolytic] streptococci may seem low, but as otitis-prone children are heavy consumers of antibiotics, the impact on the development of antibiotic resistance among pathogens causing otitis media in this group of children may be considerable," Dr. Roos and his associates added.

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Comment:Microbial Nasal Spray Wards Off Recurrent Otitis.
Publication:Family Practice News
Article Type:Brief Article
Geographic Code:4EUSW
Date:May 1, 2001
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