Penetrating gluteal injuries: Ivatury R, Rao P, Nallathambi M, et al J Trauma 22:706–709 Aug 1982

✍ Scribed by William H. Blahd Jr

• Publisher: Elsevier Science
• Year: 1983
• Tongue: English
• Weight: 230 KB
• Volume: 12
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(83)80624-6

✦ Synopsis

The authors introduce this article by stating that controlled clinical studies have demonstrated the efficacy of anti-infective drugs in the treatment of acute otitis media. They also note that adjunctive therapy has included the use of sympathomimetic and antihistaminic agents on the presumption that these drugs will improve eustachian tube patency and promote resolution of the underlying pathology. The value of these adjunctive agents, however, has not been clearly demonstrated. The authorS investigated the effectiveness of an antihistamine-decongestant treatment of acute otitis media with effusion when used in conjunction with the broad-spectrum antibiotic amoxicillin. Sixty-seven patients, ages seven months to 15 years, were involved in the study. Otitis media was diagnosed when the tympanic membrane was erythematous and immobile to pneumotoscopy. Tympanometry was performed to obtain objective data in support of the diagnosis of middle ear effusion. The patients were divided into two treatment groups. Group 1 received amoxicillin elixir orally at a dose of 50 mg/kg/day up to a maximum of 750 rag/day in three divided doses, and Naldecon elixir orally at a dose proportioned to deliver approximately 1 mg/kg/day phenylephrine, 3 mg/kg/day phenylpropanolamine, 0.35 mg/kg/day chlorpheniramine, and 1 mg/kg/day phenyltoloxamine in four divided doses. Group 2 received amoxicillin elixir orally at a dose of 50 mg/kg/day up to a maximum of 750 mg/kg in three divided doses and a placebo elixir. The duration of therapy with both drugs was 14 days. There was no significant difference between the study and placebo groups with respect to the mean duration of earache or cough. There was, however, a significant difference between the groups in the duration of nasal congestion, with a mean of six days in the treated group and nine days in the placebo group. Also, on day 14 of the investigation 28% of the Naldecon group met criteria for effusion, in contrast to 54% of the placebo group. The authors conclude that the use of Naldecon, in conjunction with an appropriate antibiotic, is an efficacious regimen for treating nasal congestion which frequently accompanies acute 0titis media with effusion. The incidence of persistent middle ear effusion is less in patients given an antihistamine-decongestant when compared to placebo.