Immunostimulant as an adjuvant therapy on Toll-like receptor concentration in children with acute otitis media

Abstract

Abstract Background Acute otitis media (AOM) is the commonest pediatric bacterial infection, affecting up to 75% of children at some time before age 5 years. AOM is among the primary reasons for antibiotic prescriptions in pediatric outpatients. This study aimed to detect the value of immunostimulant as an adjuvant therapy with antibiotics for treatment of acute otitis media in children. This study included 60 children suffering from acute otitis media; their age ranged from 3 to 5 years during the period from May 2018 to March 2019. The patients in this study were divided into 2 groups: group A included 30 patients with AOM who received amoxicillin and clavulanic acid antibiotic at attack of AOM. Group B included 30 patients with AOM who received the same antibiotic with immunostimulant (Echinacea extract) for 3 months. Samples of blood were taken from all patients to detect the level of Toll-like receptor by real-time PCR, before and after 3 months of antibiotic and immunostimulant therapy. All cases underwent assessment including complete history taking, otoscopic examination of the ear, and blood sample to detect the level of Toll-like receptor (TLR) before and after the therapy by real-time PCR. Results There was a significant (P < 0.05) decrease in the TLR2 expression in antibiotic-treated patients than its expression before treatment. On the other hand, there was a significant (P < 0.05) increase in the TLR2 expression in immunostimulant plus antibiotic-treated patients than its expression before treatment; there was a high significant (P < 0.001) increase in the expression of TLR2 in the immunostimulant plus antibiotic than the antibiotic-treated patients. Conclusion The role of antibiotics against bacterial infection causing acute otitis media can be enhanced by immunostimulant which increases the expression of Toll-like receptors which play a major role stimulating immune system to resist bacterial infection.