Possibilities of effective topical therapy in treatment of acute otitis media in children: A review

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Abstract

Acute otitis media (AOM) is a common infection of the middle ear in children with predominant symptoms of pain and hearing impairment. If antibiotics are prescribed, they take time to act on the inflammatory process, so the main focus is on relieving pain. Topical anesthetics have the advantage of having fewer systemic side effects when analgesic is used. The review covers a systematic analysis of the literature on the problem of AOM in children for the period from 1990 to 2021. Analgesic ear drops with lidocaine and phenazone can provide first-line pain relief for otitis media without systemic side effects such as gastrointestinal disorders and nausea and can maintain a wait-and-see attitude towards saving antibiotics. A combined drug containing a combination of the anesthetic lidocaine and the anti-inflammatory drug phenazone shows optimal action to eliminate pain and inflammation in children with AOM. The drug, which is recommended from the birth of a child and included in the National clinical guidelines for the treatment of AOM (2021), can be prescribed by a pediatrician and a general and family practitioner.

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About the authors

Tatiana I. Garashchenko

Pirogov Russian National Research Medical University; National Medical Research Center for Otorhinolaryngology

Email: payganova-natella@yandex.ru
ORCID iD: 0000-0002-5024-6135

D. Sci. (Med.), Prof., Pirogov Russian National Research Medical University, National Medical Research Center for Otorhinolaryngology

Russian Federation, Moscow; Moscow

Lidia I. Ilenko

Pirogov Russian National Research Medical University

Email: payganova-natella@yandex.ru
ORCID iD: 0000-0001-8375-4569

D. Sci. (Med.), Prof., Pirogov Russian National Research Medical University

Russian Federation, Moscow

Natella E. Payganova

Dr. Zaitsev ENT Clinic

Author for correspondence.
Email: payganova-natella@yandex.ru
ORCID iD: 0000-0001-7823-5422

Cand. Sci. (Med.), Dr. Zaitsev Clinic

Russian Federation, Moscow

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Supplementary files

Supplementary Files
Action
1. Fig. 1. Efficacy of the study drug for the treatment of acute otitis media in neonates and infants [35].

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2. Fig. 2. Otoscopy findings of a 7-year-old patient with severe right-sided otalgia due to congestive otitis media: a – view of the tympanic membrane before application of the study drug: opaque, thickened, without bulging in the superior posterior quadrant, hyperemic in the area of malleolus handle; b – 5 min after application of the drug: fluid at the bottom of the external auditory canal in the middle ear canal transition area; c – 25 min after application of the drug: the anterior and inferior zones of the tympanic membrane became translucent again, no hyperemia was observed in the area of the malleolus handle [35].

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