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.
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