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Evidence-Based Resource Summary

Strength of Evidence: 
4 out of 4
4 out of 4
Year Published: 

Xylitol for Preventing Acute Otitis Media in Children up to 12 Years of Age

Description of Resource: 
Acute otitis media (AOM) or middle ear infection is the most common bacterial infection among young children in the United States. Antibiotic treatment of AOM is costly and raises concerns about the development of antibiotic-resistant strains of bacteria. An alternative treatment is xylitol or birch sugar. Xylitol has been used for decades as a natural non-sugar sweetener and can reduce the risk of tooth decay. This systematic review sought to evaluate the effectiveness and safety of xylitol to prevent AOM in children up to 12 years old. Five clinical trials were identified and found that xylitol, administered in chewing gum, lozenges or syrup, can reduce the occurrence of AOM among healthy children with no acute upper respiratory infection from 30% to 22%. The preventive effect among healthy children with respiratory infection or among children prone to AOM is inconclusive.

Evidence-Based Resource Details

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Developed By: 
Cochrane Review
Developer Type: 
Non-Federal Government
Healthy People 2020 Topic Area(s): 
Hearing and Other Sensory or Communication Disorders
Healthy People 2020 Objectives: 
Resource Type: 
Systematic Review
Azarpazhooh A, Lawrence HP, Shah PS. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev [Internet]. 2016 [cited 2017 Dec 29];(8). Art. No.: CD007095. doi: 10.1002/14651858.CD007095.pub3. Available from: