Successive medical treatment versus watchful waiting in chronic otitis media with effusion

Abstract

Objective: Management of otitis media with effusion (OME) is still an unresolved problem. Although watchful waiting gained popularity, it may not be applicable in the developing countries where medical and surgical treatments are being used more promptly. The aim of our study was to compare consecutive use of medical therapies with watchful waiting.

Materials and Methods: A randomized and prospective study was planned. One group of patients with chronic OME was treated with a 3-step treatment protocol consisting of amoxicillin, amoxicillin clavulanic acid and trimethoprim sulfamethoxazole along with decongestants and antihistamines. The other group of patients was followed on a basis of watchful waiting.

Results: A total of 70 patients were included in the study, 36 of them were in the watchful waiting group and 34 of them were in the treatment group. The recovery rate in the treatment group (65%) was found to be significantly higher than the watchful waiting group (36%) (p=0,032).

Conclusion: Considering worldwide increase in the antibiotic resistances and economical concerns, watchful waiting should be chosen in uncomplicated patients. Successive medical treatment may provide a viable alternative when watchful waiting is not applicable and surgery is anticipated.