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Evidence summaries

Xylitol for Prevention of Acute Otitis Media

The prophylactic administration of xylitol among healthy children with no acute upper respiratory infection attending day care centres reduces the occurrence of AOM by 25%. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 5 included 5 studies with a total of 3 405 children. Four of the studies were conducted in Finland.

In three RCTs with a total of 1 826 healthy Finnish children attending day care, there was a reduced risk of occurrence of AOM in the xylitol group (in any form) compared to the control group (RR 0.75; 95% CI 0.65 to 0.88). The effect of xylitol in reducing AOM among healthy children during a respiratory infection (RR 1.13, 95% CI 0.83 to 1.53; 1 study, n=1 253), or among otitis-prone healthy children (RR 0.90, 95% CI 0.67 to 1.21; 1 study, n=326) was inconclusive.

Xylitol chewing gum was superior to xylitol syrup in preventing AOM among healthy children (RR 0.59; 95% CI 0.39 to 0.89; 1 study, n=338) but not during respiratory infection (RR 0.68; 95% CI 0.43 to 1.07; 1 study, n=484). There was no difference between xylitol lozenges and xylitol syrups in preventing AOM among healthy children (RR 0.77; 95% CI 0.53 to 1.11; 1 study, n=335) or among children during respiratory infection (RR 0.74; 95% CI 0.47 to 1.14; 1 study, n=488). Similarly, no difference was noted between xylitol chewing gum and xylitol lozenges in preventing AOM among healthy children (RR 0.73; 95% CI 0.47 to 1.13; 1 study, n=355) or among children during respiratory infection (RR 0.92; 95% CI 0.59 to 1.46; 1 study, n=558). Among the reasons for drop-outs, there were no significant differences in abdominal discomfort and rash between the xylitol and the control groups.

Note

    References

    • Azarpazhooh A, Lawrence HP, Shah PS. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev 2016;(8):CD007095. [PubMed]

Primary/Secondary Keywords