Can vaccination against pneumococci prevent otitis media with effusion

The most common cause of hearing loss in early childhood is otitis media with effusion (OME). Pre- vention of OME in preschool children will improve quality of life. The authors aimed to determine, by the best available published evidence, whether vaccination against pneumococci effectively prevents OME. The study design was based on systematic review (SR) of randomized con- trolled trials (Level 1a evidence). The medical literature available through searching Medline database was reviewed using the following keywords ''Otitis media with effusion,'' ''secretory otitis media,'' or ''glue ear,'' and ''vaccination'' limiting the search to randomized controlled trials (RCTs) conducted on children (0-18 years), pub- lished in English, in the last 10 years. Results of effects of vaccination on prevention of OME from the included RCTs were utilized to conduct a meta-analysis to find out the preventive value of antipneumococcal vaccination. Three RCTs were identified conforming to the inclusion criteria. Meta-analysis of results showed no significant preventive advantage for antipneumococcal vaccination. Based on the results it was confirmed that neither primary nor secondary prevention by antipneumococcal vaccination has a benefi- cial impact on OME. More RCTs should be conducted to study the effect of vaccination on OME. Level of evidence: 1a, Systematic Review of Randomized Controlled Trials.