The role of inflammatory mediators and anti-inflammatory drugs in otitis media.

Despite multiple studies, the role of anti-inflammatory drugs in the treatment of AOM and OME is unclear. Although the AHCPR was against the use of steroids in OME, other studies suggest a possible role with potential cost savings and a decrease in the need for surgery in some patients. But the risk-benefit ratio of steroid treatment is unclear. There is some evidence that NSAIDs may decrease otalgia associated with AOM, but no proof that NSAIDs reduce or prevent inflammatory changes in the middle ear associated with AOM and OME.