Therapy for otitis-prone children in Tenshi hospital

With the recent emergence and increases of multiple-drugs-resistant Strepto coccus pneumoniae, we have been seeing an increasing number of infants with intractable recurrent otitis media which is resistant to the general conse rvative out-patient treatments such as oral administration of medicines or tympanotomy. In this study, we investigated the inflammation-causing bacter ia in the infants with otitis media which were treated in our hospital from January to December in 1997, and in six serious cases among them, we measu red IgG subclass and specific IgG2 antibody to S. pneumoniae to examine the m. As a result, S. pneumoniae was found to be the cause in 45% of the cases of initial development of otitis media, and in 88% of them the S. pneumoni ae was penicillin-resistant. The level of specific IgG2 antibody to S. pneu moniae was low in all the cases, whereas IgG2 subclass was deficient only i n one out of the six cases; from these findings, the selectively low level of immune status was thought to be the cause of the recurrences of otitis m edia. In two cases, clinical condition was markedly improved by immunoglobu lin substitute therapy, which demonstrates that immunoglobulin is effective for the intractable recurrent otitis media in infants. (C) 2001 Elsevier S cience Ireland Ltd. All rights reserved.