A1 Refereed original research article in a scientific journal
Intranasal fluticasone propionate does not prevent acute otitis media during viral upper respiratory infection in children
Authors: Ruohola A, Heikkinen T, Waris M, Puhakka T, Ruuskanen O
Publisher: MOSBY, INC
Publication year: 2000
Journal: Journal of Allergy and Clinical Immunology
Journal name in source: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Journal acronym: J ALLERGY CLIN IMMUN
Volume: 106
Issue: 3
First page : 467
Last page: 471
Number of pages: 5
ISSN: 0091-6749
Abstract
Background: Acute otitis media (AOM) is the most common complication of a viral upper respiratory infection (URI) in children, The virus-induced host inflammatory response in the nasopharynx plays a key role in the pathogenesis of AOM. Suppression of this inflammatory process might prevent the development of AOM as a complication.Objective: We sought to assess the effect of intranasally administered fluticasone propionate on prevention of AOM during a viral respiratory infection.Methods: A total of 210 children (mean age, 2.1 years; range, 0.7-3.9 years) with normal middle ear status and URI of 48 hours' duration or less were randomly allocated to receive either fluticasone (100 mu g twice daily) or placebo for 7 days. The specific viral cause of the infection was determined from nasopharyngeal aspirates obtained at the first visit, The children were re-examined at the end of the 7-day medication period.Results: In the fluticasone group AOM developed in 40 (38.1%) of 105 children compared with 29 (28.2%) of 103 children receiving placebo (P = .13). The viral cause of the respiratory infection was determined in 167 (86.1%) of 194 children from whom a nasopharyngeal aspirate was obtained. In children with rhinovirus infection, AOM developed significantly more often in the fluticasone group (45.7%) than in the placebo group (14.7%, P = .005).Conclusion: Intranasally administered fluticasone does not prevent the development of AOM during URI but may increase the incidence of AOM during rhinovirus infection.
Background: Acute otitis media (AOM) is the most common complication of a viral upper respiratory infection (URI) in children, The virus-induced host inflammatory response in the nasopharynx plays a key role in the pathogenesis of AOM. Suppression of this inflammatory process might prevent the development of AOM as a complication.Objective: We sought to assess the effect of intranasally administered fluticasone propionate on prevention of AOM during a viral respiratory infection.Methods: A total of 210 children (mean age, 2.1 years; range, 0.7-3.9 years) with normal middle ear status and URI of 48 hours' duration or less were randomly allocated to receive either fluticasone (100 mu g twice daily) or placebo for 7 days. The specific viral cause of the infection was determined from nasopharyngeal aspirates obtained at the first visit, The children were re-examined at the end of the 7-day medication period.Results: In the fluticasone group AOM developed in 40 (38.1%) of 105 children compared with 29 (28.2%) of 103 children receiving placebo (P = .13). The viral cause of the respiratory infection was determined in 167 (86.1%) of 194 children from whom a nasopharyngeal aspirate was obtained. In children with rhinovirus infection, AOM developed significantly more often in the fluticasone group (45.7%) than in the placebo group (14.7%, P = .005).Conclusion: Intranasally administered fluticasone does not prevent the development of AOM during URI but may increase the incidence of AOM during rhinovirus infection.
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