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Rivista di Otorinolaringologia, Chirurgia Maxillo-Facciale,
Chirurgia Plastica Ricostruttiva, Otoneurochirurgia
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2016 September;66(3):59-62
Combined use of bromelain and N-acetylcysteine in the treatment of acute otitis media
Roberto BRUNO 1, 2
1 ENT Division, Local Health Unit of Cosenza, Cosenza, Italy; 2 University of Pisa, Pisa, Italy
BACKGROUND: Bromelain, a mixture of proteins derived from pineapple stem, has been reported to have therapeutic benefits in a variety of inflammatory diseases. N-acetylcysteine is the acetylated derivative of the amino acid L-cysteine and is a sulfhydryl-containing compound rapidly absorbed into various tissues when administered orally. N-acetylcysteine has always been used as a mucolytic agent in respiratory illnesses.
METHODSː The therapeutic efficacy of a 300-mg daily dose of bromelain in association with 1200 mg/day of N-acetylcysteine and combined with an antibiotic treatment was tested in a group of patients with acute otitis media (AOM) or recurrent acute otitis media (RAOM), while another group of patients suffering from the same pathologies were treated with antibiotics and corticosteroid-based aerosol therapies for local use. A total of 98 patients (aged 12 to 48) were enrolled in the study. Patients were examined at a first observation (T0), at the end of the treatment (T10) and 10 days after the end of the treatment (T20). Evaluations were carried out by means of a questionnaire of self-evaluation and through instrumental exams: audiometric and impedance testing.
RESULTSː The outcomes have shown efficacy both in the reduction of symptoms and in the healing rate, in patients treated with a combination of bromelain and N-acetylcysteine.
CONCLUSIONSː Based on the excellent clinical results obtained in this study, it appears that the association of 150 mg of bromelain and 600 mg of N-acetylcysteine as an anti-edema, anti-inflammatory and mucolytic treatment should be considered as a beneficial addition to the conventional therapeutic protocol for AOM and RAOM.