Anti-inflammatories and Antibacterials for Otitis Media Flurbiprofen appears more effective than feprazone in serous otitis media In an open, 4-wee\<. study 28 children, of mean age 7.9 years, were randomly assigned to treatment with flurbiprofen 100mg daily or feprazone 200mg daily for serous otitis media. Impedance measurements were carried out using a Middle-Ear Analyzer 1723. Audiometric improvement was observed in 57% of patients on flurbiprofen and 30% of patients on feprazone. The difference between the groups was significant (p 0.05). Tympanograms showed improvement in 32% of patients on flurbiprofen and 17% on feprazone; and stapedial reflex had reappeared in 2 patients in each group at 4 weeks. Thus, it appears that flurbiprofen is slightly more effective in the treatment of serous otitis media than feprazone.

=

Teatini, G.P.: Drugs Under Experimental and Clinical Research 10: 713-717 (1984)

... and trimethoprim is a good alternative to amoxycillin in acute cases The efficacy of trimethoprim in the treatment of acute otitis media was compared with that of amoxycillin in a randomised, single-blind study involving 27 boys and 23 girls aged 1-12 (mean age 5.28) years. At least 60% (30/50) of the patients had a history of recurrent otitis media over the preceding 12 months (a mean of 2.2 episodes) and at the time of the study all had symptoms and signs of acute otitis media. Those with an allergy to penicillin or the components of co-trimoxazole [trimethoprim + sulfamethoxazole] were excluded, along with patients having a perforated ear drum. 25/50 patients received amoxycillin 125mg tid (as 5ml of syrup/dose) while 25/50 patients received either trimethoprim 50mg bid (if aged under 6 years) or 100mg bid (if aged over 6 years), Symptoms and signs were noted daily during the trial and eardrum appearance was scored at entry and on day 7 of the study. Throat swabs were also taken before and after treatment. One child was excluded from the trial because of intercurrent illness and another withdrew because they failed to improve on trimethoprim. On entry the mean symptom scores for the trimethoprim and amoxycillin group members were 7.88 and 7,80, respectively (symptoms being pain, hearing loss, catarrh, loss of activity, nausea, vomiting and diarrhoea, scoring 0-3 from absent to severe). By day 7 the mean symptom scores had dropped to 1.57 and 0.67, respectively. For the amoxycillin group severe symptoms had resolved within a mean of 2.46 days vs 3.67 days for members of the trimethoprim group. Symptoms had entirely resolved within a mean of 3,88 vs 5.08 days for the respective groups, The differences between the 2 groups were not statistically significant. In 24/25 patients the eardrum was initially either red or pink in the trimethoprim group, This number had diminished to 2/25 by day 7. Corresponding values for the amoxycillin group were 21/25 and 1/25 patients. 12 patients in the trimethoprim group compared with 14 in the amoxycillin group had eardrums bulging on entry. By day 7, 2 patients from the former group and none from the latter still had bulging eardrums. 19/25 patients initially had a dull light reflex (trimethoprim group) compared with 20/25 patients from the amoxycillin group. Only 5 and 1 patients, respectively, had dull light reflexes by day 7. 20 patients from the trimethoprim group and 23 patients from the amoxycillin group had normal light reflexes b da 7 (compared with 6 and 5 patients, respectively, at entry). y y . 18/25 ~atients from the amoxycillin group had ~ecovered by ?ay 7 compared with 14/24 patients from the tnmethopnm group. Seven out of 2? and 6/24 pat.lents, respectlv.ely, had greatly improved while 0/25 and 4/24, respectively, had Impr~ved shghtly: On~ patient from the tnmethoprim group required erythromycin before Improveme~t was noticed: Bactenolog~cal results were difficult to interpret because some patients Improved despite Isolation of resistant bactena from their throat swabs. No serious side effects were noted during therapy although lethargy and malaise were reported from members of both groups and one patrent from the amoxycillin group developed oral candidosis. From .t~ial res~lt~, tri':1ethoprim appears t? be an effective alternative to amoxycillin for the treatment of acute otitiS media rn children who are allergic to penicillin. Backhouse. C.I. and Woods, P.: Practitioner 229: 51-54 (Jan 1985)

0156-2703/85/0216-0011 /0$01.00/0

© ADIS Press

INPHARMA® 16 Feb 1985

11