Xylitol in preventing acute otitis media

Vaccine. 2000 Dec 8:19 Suppl 1:S144-7. doi: 10.1016/s0264-410x(00)00294-2.


Xylitol is a polyol sugar alcohol and is referred to as birch sugar, because it can be produced from birch. Natural sources of xylitol include plums, strawberries, raspberries and rowan berries. Xylitol inhibits the growth of Streptococcus pneumoniae and it inhibits the attachment of both pneumococci and Haemophilus influenzae on the nasopharyngeal cells. In two clinical trials xylitol was found efficient to prevent the development of acute otitis media with a daily dose of 8.4-10 g of xylitol given in five divided doses. The efficacy in these 2-3 months follow-up trials was approximately 40% when chewing gum was used and approximately 30% with xylitol syrup. The need to use antimicrobials reduced markedly when using xylitol. In a high-risk group of children with tympanostomy tubes xylitol was ineffective in preventing otitis. Xylitol appears to be an attractive alternative to prevent acute otitis media. A more practical frequency of doses should be found before its use can be widely recommended.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acoustic Impedance Tests
  • Acute Disease
  • Administration, Oral
  • Bacterial Adhesion / drug effects*
  • Cells, Cultured
  • Chewing Gum
  • Child Day Care Centers
  • Child, Preschool
  • Clinical Trials as Topic
  • Dental Caries / prevention & control
  • Dosage Forms
  • Double-Blind Method
  • Follow-Up Studies
  • Haemophilus influenzae / drug effects*
  • Haemophilus influenzae / physiology
  • Humans
  • Hygiene
  • Infant
  • Middle Ear Ventilation
  • Moraxella catarrhalis / drug effects*
  • Moraxella catarrhalis / physiology
  • Nasopharynx / microbiology
  • Otitis Media / prevention & control*
  • Randomized Controlled Trials as Topic
  • Respiratory Tract Infections / complications
  • Streptococcus mutans / drug effects
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / physiology
  • Sucrose / adverse effects
  • Sweetening Agents / administration & dosage
  • Sweetening Agents / therapeutic use
  • Xylitol / administration & dosage
  • Xylitol / therapeutic use*


  • Chewing Gum
  • Dosage Forms
  • Sweetening Agents
  • Sucrose
  • Xylitol