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 language | English (US) |
|---|---|
| Pages (from-to) | 221-230 |
| Number of pages | 10 |
| Journal | International Journal of Pediatric Otorhinolaryngology |
| Volume | 67 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2003 |
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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 journal › Article
}
TY - JOUR
T1 - Middle ear fluid histamine and leukotriene B4 in acute otitis media
T2 - Effect of antihistamine or corticosteroid treatment
AU - McCormick, David P.
AU - Saeed, Kokab
AU - Uchida, Tatsuo
AU - Baldwin, Constance D.
AU - Deskin, Ronald
AU - Lett-Brown, Michael A.
AU - Heikkinen, Terho
AU - Chonmaitree, Tasnee
PY - 2003/3
Y1 - 2003/3
N2 - 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.
AB - 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.
KW - Acute otitis media
KW - Antihistamine
KW - Corticosteroid
KW - Histamine
KW - Leukotriene B4
UR - http://www.scopus.com/inward/record.url?scp=0037334539&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037334539&partnerID=8YFLogxK
U2 - 10.1016/S0165-5876(02)00372-5
DO - 10.1016/S0165-5876(02)00372-5
M3 - Article
C2 - 12633920
AN - SCOPUS:0037334539
VL - 67
SP - 221
EP - 230
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
SN - 0165-5876
IS - 3
ER -