Rinogermina

Acute otitis media (AOM) is the most common disease in children, with more than 80% of those under three years experience at least one episode, and about one-third of these report a significant recurrence of episodes. In the recent years, several studies reported that a normal nasopharyngeal flora inhibits the growth of common otopathogens, suggesting that the keeping of an “adequate” nasopharyngeal flora might prevent the occurrence of upper respiratory tract infections, including AOM.

Objective:

To determine whether five-month treatment with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray prevents the recurrence of AOM episodes and the dispensation of antibiotics in children with diagnosis of recurrence AOM.

Design, setting, and participants:

Observational prospective cohort study including children aged 1 to 6 years and with diagnosis of recurrence AOM from 31 family pediatricians. 81 children were enrolled in the study from September 2016 to the end of the five therapeutic cycles of the Streptococcus salivarius 24SMB and Streptococcus oralis 89a supplied 7 days each month for 5 consecutive months. For each treated child, one untreated child was randomly selected, to be 1:1 matched for gender, age, and follow-up.

Results:

158 children (79 treated and 70 untreated) were included into the analysis (mean age, 3.9 years; 47% female). Results suggest a reduction of AOM in treated children (adjusted incidence rate ratio, 31%, 95% confidence interval, -4% to 54%) compared with those untreated, which is however not significant. Moreover, treated children resulted in a significantly reduction of antibiotic dispensation (24%, 1% to 41%).

Conclusion:

Our findings suggest that the intermittent treatment of children with diagnosis of recurrent AOM with a nasal spray containing Streptococcus salivarius 24SMB and Streptococcus oralis 89a for a period of five months, might be effective in preventing recurrent episodes of AOM and the antibiotics use. Additional larger studies to address this important clinical problem are recommended.