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Oral prednisolone = placebo in children with otitis media with effusion (OSTRICH)
Clinical Question
Are corticosteroids more effective than placebo in the resolution of otitis media with effusion (OME) and in restoring hearing in children with OME with hearing loss?
Bottom line
In this study, children with OME and hearing loss treated with steroids experienced no significant improvement in hearing compared with placebo-treated children. 1b
Reference
Study design: Randomized controlled trial (double-blinded)
Funding: Government
Setting: Outpatient (specialty)
Synopsis
These authors randomized children with OME and hearing loss for at least 3 months to receive 7 days of oral prednisolone (20 mg/day for children 2 to 5 years of age; 30 mg/day for children 6 to 8 years of age; n = 193) or matching placebo (n = 187). The children had at least 20 dB loss in any of the typical speech frequencies (0.5 - 4 KHz). The researchers reassessed the children's hearing 4 weeks after completing treatment, and then again at 6 months and 12 months. Although more than one-third of the children had meaningful improvement in hearing, at the end of each follow-up interval, the researchers found no statistically significant differences between the treatment groups. There was also no difference in the use of tympanostomy tubes. Approximately 1 in 8 of the children in each group did not complete the 1-year follow up. Only one child experienced an adverse event related to treatment.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Comments
Had no idea anyone would consider using prednisolone for this purpose anyway. Overkill
Il aurait été intéressant qu’ils comparent les stéroïdes intranasal au placebo à la place.
Excellent
Good poem
When did using a sledge hammer like prednisone become an acceptable way to crack a walnut? I find that prednisone is being used to treat minor problems without considering the adverse effects.