Middle ear fluid histamine and leukotriene B4 in acute otitis media

Effect of antihistamine or corticosteroid treatment

David P. McCormick, Kokab Saeed, Tatsuo Uchida, Constance D. Baldwin, Ronald Deskin, Michael A. Lett-Brown, Terho Heikkinen, Tasnee Chonmaitree

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: Two potent mediators of acute inflammation, histamine and leukotriene B4 (LTB4), have been shown to play important roles in the pathogenesis and clinical course of acute otitis media (AOM) in children. The purpose of this study was to evaluate the ability of adjuvant drugs, antihistamine and corticosteroid, in reduction of the levels of histamine and LTB4 in the middle ear and their ability to improve outcomes of AOM. Methods: Eighty children with AOM (aged 3 months to 6 years) were enrolled in a prospective, randomized, double-blind, placebo controlled study. All children received one dose of intramuscular ceftriaxone and were randomly assigned to receive either chlorpheniramine maleate (0.35 mg/kg per day) and/or prednisolone (2 mg/kg per day) or placebos three times a day for 5 days. Tympanocentesis was performed at enrollment and after 5 days of adjuvant drug treatment. MEFs were collected for bacterial and viral studies and histamine and LTB4 levels. The subjects were followed for the duration of middle ear effusion or up to 3 months. Results: Histamine or LTB4 levels in the MEF after 5 days of treatment were not significantly reduced by adjuvant drug treatment. However, subjects receiving corticosteroid had a lower rate of treatment failure during the first 2 weeks and shorter duration of middle ear effusion. Conclusions: Five day of antihistamine or corticosteroid treatment does not reduce the levels of histamine or leukotriene B4 in the MEF of children with AOM. Positive clinical outcomes of AOM cases associated with corticosteroid treatment needs to be confirmed in a larger clinical trial of children with intact tympanic membranes, who do not receive tympanocentesis.

Original languageEnglish (US)
Pages (from-to)221-230
Number of pages10
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume67
Issue number3
DOIs
StatePublished - Mar 2003

Fingerprint

Leukotriene B4
Histamine Antagonists
Otitis Media
Middle Ear
Histamine
Adrenal Cortex Hormones
Otitis Media with Effusion
Placebos
Pharmaceutical Preparations
Chlorpheniramine
Therapeutics
Inflammation Mediators
Tympanic Membrane
Ceftriaxone
Prednisolone
Treatment Failure
Clinical Trials

Keywords

  • Acute otitis media
  • Antihistamine
  • Corticosteroid
  • Histamine
  • Leukotriene B4

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Middle ear fluid histamine and leukotriene B4 in acute otitis media : Effect of antihistamine or corticosteroid treatment. / McCormick, David P.; Saeed, Kokab; Uchida, Tatsuo; Baldwin, Constance D.; Deskin, Ronald; Lett-Brown, Michael A.; Heikkinen, Terho; Chonmaitree, Tasnee.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 67, No. 3, 03.2003, p. 221-230.

Research output: Contribution to journalArticle

McCormick, DP, Saeed, K, Uchida, T, Baldwin, CD, Deskin, R, Lett-Brown, MA, Heikkinen, T & Chonmaitree, T 2003, 'Middle ear fluid histamine and leukotriene B4 in acute otitis media: Effect of antihistamine or corticosteroid treatment', International Journal of Pediatric Otorhinolaryngology, vol. 67, no. 3, pp. 221-230. https://doi.org/10.1016/S0165-5876(02)00372-5
McCormick, David P. ; Saeed, Kokab ; Uchida, Tatsuo ; Baldwin, Constance D. ; Deskin, Ronald ; Lett-Brown, Michael A. ; Heikkinen, Terho ; Chonmaitree, Tasnee. / Middle ear fluid histamine and leukotriene B4 in acute otitis media : Effect of antihistamine or corticosteroid treatment. In: International Journal of Pediatric Otorhinolaryngology. 2003 ; Vol. 67, No. 3. pp. 221-230.
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