Int. Adv. Otol. 2009; 6(1); 11-17

Successive medical treatment versus watchful waiting in chronic otitis media with effusion
Omer Afsin Ozmen,  Aydan Genc, Suay Ozmen, Emel Mavis Kulak Kayikci, Sarp Sarac, Levent Sennaroglu, Ergin Turan
Uludag University Faculty of Medicine, Department of Otolaryngology Head and Neck Surgery, Bursa, Turkey.  oaozmen@yahoo.com

Objective: Management of otitis media with effusion (OME) is still an unresolved problem. Although watchful waiting gained
popularity, it may not be applicable in the developing countries where medical and surgical treatments are being used more
promptly. The aim of our study was to compare consecutive use of medical therapies with watchful waiting.

Materials and Methods: A randomized and prospective study was planned. One group of patients with chronic OME was
treated with a 3-step treatment protocol consisting of amoxicillin, amoxicillin clavulanic acid and trimethoprim sulfamethoxazole
along with decongestants and antihistamines. The other group of patients was followed on a basis of watchful waiting.

Results: A total of 70 patients were included in the study, 36 of them were in the watchful waiting group and 34 of them were
in the treatment group. The recovery rate in the treatment group (65%) was found to be significantly higher than the watchful
waiting group (36%) (p=0,032).

Conclusion: Considering worldwide increase in the antibiotic resistances and economical concerns, watchful waiting should
be chosen in uncomplicated patients. Successive medical treatment may provide a viable alternative when watchful waiting is
not applicable and surgery is anticipated.