169 The Efficacy of a Nasal Corticosteroid Ciclesonide for the Treatment of Serous Otitis Media in Atopic Children

BACKGROUND: Since chronic inflammation is the histopathologic landmark of otitis media with effusion, clinical observations led us to believe that the use of a Nasal Corticoteroid Ciclesonide may be more effective than an oral antibiotic in the treatment of serous otitis media in atopic children. METHODS: We studied forty pediatric patients (age 6–11 years) in a randomized open labeled 2-week trial to compare the efficacy of the nasal corticosteroid Ciclesonide 50 mcg/nostril 2 sprays per nostril once a day to an oral antibiotic Amoxicillin/Clavulanate potassium (90 mg/kg/day in 2 divided doses every 12 hours) for the treatment of otitis media with effusion. The efficacy of the treatment options was assessed using pneumatic otoscopy, impedance tympanometry and audiometry to monitor the clinical course of the middle ear effusion in both treatment groups. RESULTS: In the group nasal corticosteroid Ciclesonide a resolution of otitis media with effusion occurred at the 8(th) day. In contrast in the group treated with the oral antibiotic the resolution of otitis media with effusion occurred on the 14(th) day. CONCLUSIONS: In conclusion, the nasal corticosteroid Ciclesonide is more effective than an oral antibiotic. The nasal corticosteroid Ciclesonide may be a safer and shorter therapy given the safety issues with long term use of systemic antibiotics in atopic children.