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Treatment of chronic suppurative otitis media with Broncasma Berna.

Abstract

Broncasma Berna, an inactivated bacterial vaccine, has been safely used throughout the world for 30 years for the prevention or treatment of various infectious processes. Until now, there has been no published report regarding its use as a treatment for chronic suppurative otitis media. In this small study, five such patients (median age: 57 years) underwent a series of seven 0.05-ml injections of Broncasma Berna. In all cases, their otorrhea diminished markedly and their tympanic membranes were almost completely dry. The cost of treatment was extremely low.

Introduction

Conservative medical treatment of noncholesteatomatous chronic suppurative otitis media is necessary to control active otorrhea. This condition can be treated with frequent suction cleaning and topical antibiotic eardrops. In uncomplicated cases, systemic antibiotics should not be used; they should be reserved for intractable otorrhea caused by a culture-specific pathogen. [1] Even then, antibiotics do not always cure chronic suppurative otitis media. Furthermore, they can lead to resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA).

Considerable evidence suggests that otitis media can he prevented by systemic immunization with pneumococcal vaccines or Hemophilus influenzae vaccines. [2] But the author has found no report in the literature regarding the use of a vaccine for the treatment of chronic suppurative otitis media.

The inactivated bacterial vaccine Broncasma Berna has been used to treat chronic bronchitis and its complications, for asthma of bacterial origin, and for chronic sinusitis and rhinitis. It has few or no side effects. This article describes the use of Broncasma Berna for the treatment of chronic suppurative otitis media in five patients.

Patients and methods

The author treated three men and two women (median age: 57 years) who had chronic suppurative otitis media and considerable otorrhea from a tympanic membrane perforation. Cultures of the discharged fluid identified S aureus in two patients, MRSA in two, and Pseudomonas aeruginosa in one.

Patients were administered subcutaneous injections of 0.05 ml of Broncasma Berna once every 4 to 7 days; each patient received a total of seven injections. No other medication for chronic otitis media was used.

Results

Two months following the completion of treatment, the amount of otorrhea in all patients had decreased markedly, and all patients expressed satisfaction with their treatment. During an 18-month followup period, no patient experienced a relapse. Cultures of what discharge remained isolated no evidence of bacteria in two patients (one who had had S aureus and one who had had MRSA). The other three patients still exhibited organisms on culture, but their tympanic membranes were almost completely dry. The cost of this treatment was extremely low.

Discussion

Broncasma Berna is a product of the Swiss Serum and Vaccine Institute Berne. A 1-ml dose contains 50 x [10.sup.6] pneumococcal types I, II, and III; 40 x [10.sup.6] streptococci; 500 x [10.sup.6] staphylococci; 60 x [10.sup.6] Neisseria catarrhalis; 20 x [10.sup.6] Gaffkya tetragena; 250 x [10.sup.6] P aeruginosa; 40 x [10.sup.6] Klebsiella pneumoniae; and 40 x [10.sup.6] H influenzae and conservans (maximum 0.4% phenol). Even though a different dosing schedule was used in this study, the usual vaccine regimen consists of five escalating doses: 0.1 ml, 0.3 ml, 0.5 ml, 0.7 ml, and 1.0 ml. [3]

Over the past 3 decades, millions of doses of Broncasma Berna have been administered in many countries. During all that time, the Swiss Serum and Vaccine Institute Berne has received no reports of anaphylactic reactions or any other significant complications. In Japan, Broncasma Berna has been used for a quarter of a century, and no significant side effects have ever been reported.

In this study, in which the dose was relatively small, no patient complained of spontaneous pain or fever, although one did complain of a slight tenderness at the injection site the following day.

References

(1.) Jung TT. Hanson JB. Classification of otitis media and surgical principles. Otolaryngol Clin North Am 1999;32:369-83.

(2.) Giebink GS. Vaccination against middle-ear bacterial and viral pathogens. Ann N Y Acad Sci 1997;830:330-52.

(3.) Nakatani M. On the treatment of recurrent tonsillitis by vaccination. Curr Med Res Opin 1998;14:111-6.
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Article Details
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Comment:Treatment of chronic suppurative otitis media with Broncasma Berna.
Author:Nakatani, Masaki
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Geographic Code:1USA
Date:Aug 1, 2001
Words:701
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