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Charles D. Bluestone, MD
Children's Hospital of Pittsburgh Pittsburgh, Pa

Jerome O. Klein, MD
Boston City Hospital Boston, Mass

JAMA. 1995;273(9):697.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—We are concerned about several aspects of the report by Dr Kleinman and colleagues¹ on use of tympanostomy tubes in children. Children with recurrent acute otitis media who fail antibiotic prophylaxis are appropriately considered for placement of ventilating tubes but were identified as "inappropriate" or "equivocal" in the report. We have identified tube insertion for this indication in our publications,² and there is additional convincing evidence to support this usage.^3,4 A recent clinical trial reported in 1992 by Casselbrant and coworkers⁵ addressed this question and again supported use of tympanostomy tubes for children with recurrent acute otitis media who fail antibiotic prophylaxis. The rapid emergence of resistant bacteria such as penicillin-resistant Streptococcus pneumoniae during the past few years may make indications for surgical intervention an even more important alternative to antimicrobial treatment and prophylaxis.

We participated in the panel convened by Value Health . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Margaret A. Winker, MD, Senior Editor.

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