Abstract

MOREIRA, Margarida; SILVA, Margarida Ferreira da; COSTA, Francisco Pinto da  and  MIRANDA, Catarina. Xylitol for prevention of acute otitis media in children. Rev Port Med Geral Fam [online]. 2014, vol.30, n.1, pp.32-36. ISSN 2182-5173.

Aim: Acute otitis media (AOM) is a common illness in children and accounts for a significant proportion of antibiotic prescriptions. However antibiotic use is controversial since the disease may be self-limiting and recurrent in childhood and excessive antibiotic use may lead to increased bacterial resistance. Xylitol has potential in preventing AOM. This review examines the evidence for the effectiveness of xylitol in preventing AOM in children. Data sources: National Guideline Clearinghouse, NHS Evidence, Canadian Medical Association, Scottish Intercollegiate Guidelines, Evidence Based Medicine, InfoPOEMs, TRIP, The Cochrane Library, DARE, Bandolier and Medline. Review methods: A search was performed between January 2000 and May 2012, in Portuguese, English and Spanish, using otitis media and xylitol as MeSH terms. The Strength of Recommendation Taxonomy (SORT) scale was used to assess level of evidence and strength of recommendations. Results: Of the 106 articles found, 3 met the inclusion criteria. Two meta-analyses found evidence for the efficacy of xylitol in reducing the occurrence of AOM in children (Level of Evidence 2). A systematic review concluded that there was poor quality evidence for the use of xylitol in preventing AOM (Level of Evidence 2). Conclusions: Current evidence shows the efficacy of xylitol in preventing AOM in children (SORT B). Questions remain regarding the dose of xylitol, its long-term benefits, the duration of treatment, and the target population. Research on routes of administration providing better adherence to treatment in all age groups is needed.

Keywords : Xylitol; Acute Otitis Media.

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