montelukast and Otitis-Media

Otitis media (OM) is one of the most common childhood disorders and has been associated with an alarming rise in prevalence. Because medical therapy with antibiotics, antihistamines, decongestants, and corticosteroids has no demonstrable efficacy in the treatment of OM, the mainstay of treatment is surgical intervention. Although effective, surgical treatment is quite expensive and exposes patients to the risks associated with general anesthesia. Results of recent studies suggest that locally produced leukotrienes may play a role in the pathogenesis of OM. As such, a potential candidate for treatment of OM is the leukotriene receptor antagonist, montelukast, which has been approved by the US Food and Drug Administration for the treatment of asthma and/or allergic rhinitis. If proven effective, this drug's safety/convenience profiles and indication for children as young as 6 months of age would make it suitable for treatment of OM, and perhaps even prophylaxis of OM in at-risk populations.

Topics: Acetates; Cyclopropanes; Humans; Infant; Leukotriene Antagonists; Leukotrienes; Otitis Media; Quinolines; Sulfides; Virus Diseases

Rothia mucilaginosa, previously known as Stomatococcus mucilaginosus, is a Gram-positive coccus that is part of the oropharyngeal microbiota and upper respiratory tract. It is mainly related to infections in immunosuppressed patients. Given its complex microbiological identification, its prevalence may be underestimated. We describe in this article a case of bacteraemia by Rothia in an immunocompetent paediatric patient without epidemiological or medical relevant history. In the available literature no cases of bacteraemia by Rothia mucilaginosa in immunocompetent paediatric patients have been reported. Given the characteristics of our patient, the publication of this case is of interest. Once the diagnosis of Rothia mucilaginosa has been made, the correct functioning of the immune system of the patient should be checked.

Topics: Acetates; Actinomycetales Infections; Anti-Asthmatic Agents; Asthma; Bacteremia; Communicable Diseases, Emerging; Cyclopropanes; Herpangina; Humans; Immunocompetence; Infant; Male; Micrococcaceae; Otitis Media; Quinolines; Sulfides

Leukotrienes are the major factors in the formation of edema and mucus, as well as development of tuba Eustachii dysfunction in acute otitis media. We developed an experimental acute suppurative otitis media model and compared the responses of rats to penicillin and combinations of leukotriene antagonist with respect to histopathological observations conducted in early and late phases.. A total of 83 ears from 56 Wistar rats were used in this study. Pneumococcus suspension was injected trans-tympanically into all rats. Subjects were classified into 4 different groups with 14 rats in each. In Group A, intramuscular penicillin G was injected for a period of 5 days. In Group B, intraperitoneal montelukast was injected for 21 days in addition to penicillin. In Group C, intraperitoneal montelukast isotonic NaCl in Group D was injected into rats for 21 days.. No significant difference was found between the groups, except for mucosal vascularization with respect to mucosal and TM parameters in early phases. Furthermore, considerable deviations were observed for the recuperation of TM and mucosal inflammation for groups in which subjects were injected with montelukast as compared to other groups of the study in the late phases.. When the parameters of inflammation in the rat middle ear were compared with each other, most of these parameters did not show any statistically significant beneficial effects in montelukast and penicillin groups.

Topics: Acetates; Animals; Cyclopropanes; Disease Models, Animal; Ear, Middle; Female; Mucous Membrane; Otitis Media; Penicillins; Quinolines; Rats; Rats, Wistar; Sulfides