Antihistamines and/or decongestants not recommended in children with otitis media with effusion

Clinical question: 
Are antihistamines, decongestants or combination therapy effective in children with otitis media with effusion (OME)?
Bottom line: 
Antihistamines and/or decongestants do not help and may harm when used for symptoms of OME (‘glue ear”). There was no benefit for any of the short or long-term outcomes including resolution of the fluid, hearing problems or the necessity of additional referral to specialists.
Caveat: 
These medications caused significant side-effects, such as gastro-intestinal upset, irritability, drowsiness or dizziness in approximately 10% of the patients.
Context: 
OME is a common condition in which there is fluid persisting in the middle ear. Many treatments have been suggested. Watchful waiting is the best approach with consideration of referral for evaluation by an ENT consultant if symptoms persist beyond 12 weeks.
Review CD#: 
CD003423
PEARLS No: 
30
Date: 
March, 2007
Authored by: 
Brian R McAvoy