28 Nov The use of xylitol for the prevention of Acute Otitis Media
Acute Otitis Media is one of the most common pediatric diseases (Marchisio et al. , 2004). It is also the most common reason why children are prescribed antibiotics (Wargo et al., 2014). The WHO estimates that 51,000 deaths every year in children younger than 5 years are attributed to complications of acute otitis media, primarily intracranial infections and that chronic suppurative otitis is a major cause of hearing loss in many developing countries. The WHO’s estimates suggest that worldwide 65 million to 330 million individuals develop chronic suppurative otitis media, 60% of whom will suffer from hearing impairment (Vergison et al., 2010).
The burden of AOM can have a medical, social and economic on society as well as on the quality of life of the child and family. There is a large unmet need among pediatricians and family physicians to offer prevention strategies for AOM and in turn, reduce the amount of antibiotics consumed by a pediatric population.
What is Acute Otitis Media?
An ear infection is an inflammation of the middle ear, usually caused by bacteria, that occurs when fluid builds up behind the eardrum. Anyone can get an ear infection, but children get them more frequently than adults. An ear infection, also called otitis media, is specifically an infection of the middle ear — the part that contains tiny bones that transmit sound from the eardrum to the inner ear. The middle ear produces secretions, which normally drain to the back of the throat through the Eustachian tube. The main reason why children get more middle ear infections is poor functioning of the drainage pathway (the Eustachian tube) that connects the middle ear to the back of the nose. This tube is the body’s natural way to ventilate the ear, to allow fluid to drain when the ear is infected, and to allow air to enter the ear and keep it healthy. A child’s Eustachian tube does not function as well as an adult’s tube for a variety of reasons mainly due to the fact it has not had enough time to grow and fully
develop.
Just as with all other aspects of human biology, there is a broad range of Eustachian tube function in children- some children get lots of ear infections, some get none. But overall,young children are more prone to ear infections and ear fluid. This tends to improve in most children by age 4-6, when the tube matures towards the adult level of function.
In addition to problems with the Eustachain tube, young children have immature immune systems and may be exposed to other sick children in a school or day care setting. Upper respiratory tract infections (such as colds) are more common in children, and this can make the child’s Eustachian tube function even worse, by causing swelling in the walls.
Allergies are common in children, but there is not much evidence to suggest that they are a cause of either ear infections or middle ear fluid. While allergies can and should be treated, this treatment does not seem to have much effect on ear disease. However, if the fluid doesn’t drain and builds up in the middle ear, it creates a warm, moist environment where bacteria and viruses grow. Invading bacteria or viruses thrive and result
in the pain, crankiness, and fever that signal to parents that their child has an ear infection.
Some strategies do exist to prevent the recurrence of AOM including vaccination, breastfeeding, probiotics, complimentary medicines, homeopathy,osteopathy, chiropractics and aromatherapy, however the evidence to support these strategies vary in their effectiveness (Levi et al., 2013).
Prevention
The use of xylitol for the prevention of AOM has also been explored as alternative and is supported by an number of Pediatric Associations notably, the American Academy of Pediatrics and many pediatric association have identified xylitol as preventative for otitis media however require more clinical information (Gunasekera et al., 2009),.
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