XYLITOL CHEWING GUM IN PREVENTION OF ACUTE OTITIS-MEDIA - DOUBLE-BLIND RANDOMIZED TRIAL

Objective-To examine whether xylitol, which reduces the growth of Stre ptococcus pneumoniae, might have clinical importance in the prevention of acute otitis media. Design-A double blind randomised trial with xy litol administered in chewing gum. Setting-Eleven day care nurseries i n the city of Oulu. Most of the children had had problems with recurre nt acute otitis media. Subjects-306 day care children: 149 children in the sucrose group (76 boys; mean (SD) age 4.9 (1.5) years) and 157 in the xylitol group (80 boys; 5.0 (1.4) years). Intervention-Either xyl itol (8.4 g a day) or sucrose (control) chewing gum for two months. Ma in outcome measures-The occurrence of acute otitis media and antimicro bial treatment received during the intervention and nasopharyngeal car riage of S pneumoniae. Results-During the two month monitoring period at least one event of acute otitis media was experienced by 31/149 (20 .8%) children who received sucrose compared with 19/157 (12.1%) of tho se receiving chewing gum containing xylitol (difference 8.7%; 95% conf idence interval 0.4% to 17.0%; P = 0.04). Significantly fewer antimicr obials were prescribed among those receiving xylitol: 29/157 (18.5%) c hildren had at least one period of treatment versus 43/149 (28.9%) (di fference 10.4%; 0.9% to 19.9%; P = 0.032). The carriage rate of S pneu moniae varied from 17.4% to 28.2% with no difference between the group s. Two children in the xylitol group experienced diarrhoea, but no oth er adverse effects were noted among the xylitol users. Conclusion-Xyli tol seems to have a preventive effect against acute otitis media.