Research shows that recurrent ear infections in young children may be successfully treated with erythromycin antibiotics.

Your inner ear is full of air and is connected to the outside through the eustachian tube that opens into the back of your mouth. Young children have narrow eustachian tubes that can close and fill with fluid that causes ear pressure and pain. If your doctor sees fluid causing the ear drum to bulge outward, he knows that the eustachian tube is closed and often prescribes antibiotics and a cortisone-type nasal spray. Antihistamines do not open eustachian tubes. Doctors sometimes remove tonsils and adenoids or give allergy injections, but these treatments have an extraordinarily high failure rate. Making a hole in the ear drum and inserting a tube can help relieve the pressure, but then the child isn't allowed to go swimming.

Since the eustachian tube enlarges as a child grows, the tube usually opens by itself in time and it is rarely necessary to perform surgery. However, if the doctor feels that fluid in the drum can interfere with a child's hearing or school work or that permanent damage in possible, it is reasonable to relieve this pressure by punching a hole in the ear drum and inserting a tube to keep it open.

The research shows that the buildup of fluid in the inner ear is probably caused by inactive cilia, the small hairs that line the eustachian tube and sweep fluid toward the mouth. Erythromycin antibiotics stimulate the cilia, remove fluid from the inner ear and help to relieve the discomfort. If further studies confirm the present ones, doctors will use erythromycin antibiotics for several weeks and months to treat fluid buildup in a child's ears.

By Gabe Mirkin, M.D., for CBS Radio News Checked 8/9/05

1) Xylitol chewing gum in prevention of acute otitis media: Double blind randomized trial. British Medical Journal 313: 7066 (NOV 9 1996):1180-1183. Conclusion-Xylitol seems to have a preventive effect against acute otitis media.

2) Y Sugiura, Y Ohashi, Y Nakai. Roxythromycin stimulates the mucociliary activity of the eustachian tube and modulates neutrophil activity in the healthy guinea pig. Acta Oto - Laryngologica : Suppl. 531 (1997):34-38. address: Y Sugiura, Osaka City Univ, Sch Med, Dept Otolaryngol, 1-5-7 Asahimachi, Osaka 545, Japan. Macrolides such as roxythromycin (RXM), enhance the ciliary activity.

3) Y Sugiura, Y Ohashi, Y Nakai. Roxythromycin prevents endotoxin-induced otitis media with effusion in the guinea pig. Acta Oto - Laryngologica: Suppl. 531 (1997):39-51.

Checked 8/9/05

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