Therapeutic efficacy of azithromycin and acetylcysteine in chronic otitis media with effusion

Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1351-1356. doi: 10.1007/s00405-016-4389-3. Epub 2016 Nov 21.


Otitis media with effusion (OME) is a common disease in childhood. There is no consensus on the optimal therapeutic option for OME. Considering the known efficacy of acetylcysteine (AC) and azithromycin (AZ) in the treatment of middle ear mucosa, the aim of the study was to assess their efficacy in the management of chronic OME. The study included 90 children with OME, both ears. They are divided into three groups of 30 children. Group 1 (AC) patients were treated with acetylcysteine per os, 3 × 100 mg, for 3 weeks; group 2 (AZ) with body weight adjusted dose of azithromycin for 3 days; and group 3 (AC + AZ) with a combination of acetylcysteine and azithromycin at doses described above. Three measurements were performed. On second measurement, tympanogram improvement was recorded in 45% of 60 ears in group I, 53.3% of 60 ears in group II, and 61.7% of 60 ears in group III. The percentage of improvement was highest in group III. Although between-group differences did not reach statistical significance, the results obtained appear to be clinically relevant. In conclusion, conservative therapy for chronic OME is reasonable. Although study results don't have a strong statistical differences and may not refer clinical improvement results suggest that this combination of drugs (antibiotics, bronchosecretolytics) can be useful in the treatment of OME.

Keywords: Antibiotic therapy; Bronchosecretolytic; Otitis media with effusion; Tympanometry.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Acoustic Impedance Tests
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Therapy, Combination
  • Expectorants / therapeutic use
  • Female
  • Humans
  • Male
  • Otitis Media with Effusion / drug therapy*
  • Prospective Studies


  • Anti-Bacterial Agents
  • Expectorants
  • Azithromycin
  • Acetylcysteine