Background: Acute otitis media (AOM) is the commonest pediatric bacterial infection, affecting up to 75% of
children at some time before age 5 years. AOM is among the primary reasons for antibiotic prescriptions in
pediatric outpatients. This study aimed to detect the value of immunostimulant as an adjuvant therapy with
antibiotics for treatment of acute otitis media in children. This study included 60 children suffering from acute otitis
media; their age ranged from 3 to 5 years during the period from May 2018 to March 2019. The patients in this
study were divided into 2 groups: group A included 30 patients with AOM who received amoxicillin and clavulanic
acid antibiotic at attack of AOM. Group B included 30 patients with AOM who received the same antibiotic with
immunostimulant (Echinacea extract) for 3 months. Samples of blood were taken from all patients to detect the
level of Toll-like receptor by real-time PCR, before and after 3 months of antibiotic and immunostimulant therapy.
All cases underwent assessment including complete history taking, otoscopic examination of the ear, and blood
sample to detect the level of Toll-like receptor (TLR) before and after the therapy by real-time PCR.
Results: There was a significant (P < 0.05) decrease in the TLR2 expression in antibiotic-treated patients than its
expression before treatment. On the other hand, there was a significant (P < 0.05) increase in the TLR2 expression
in immunostimulant plus antibiotic-treated patients than its expression before treatment; there was a high
significant (P < 0.001) increase in the expression of TLR2 in the immunostimulant plus antibiotic than the antibiotictreated
patients.
Conclusion: The role of antibiotics against bacterial infection causing acute otitis media can be enhanced by
immunostimulant which increases the expression of Toll-like receptors which play a major role stimulating immune
system to resist bacterial infection. |
