We explored the effectiveness of folate treatment in children with ear infections by evaluating hematologic abnormalities during antibiotic therapy. In a study involving 120 children with otitis media, we divided the participants into three groups: one received cotrimoxazole (the combination of trimethoprim and sulfamethoxazole), the second group received cotrimoxazole with folinic acid (a form of folate), and the third group was given amoxicillin.
We observed that 35% of children receiving cotrimoxazole alone developed neutropenia (a low level of neutrophils, which are essential for fighting infections), while only 17.5% in the cotrimoxazole plus folinic acid group experienced this issue. Early neutropenia was consistent among all groups and usually resolved on its own. However, late neutropenia, occurring after ten days, was specific to those treated with cotrimoxazole alone.
Importantly, the study indicated that the late neutropenia connected to cotrimoxazole use could be linked to a blockage in folinic acid metabolism. This suggests that adding folinic acid may help prevent this side effect. However, it’s worth noting that while folate treatment appears beneficial in reducing the risk of late neutropenia, the study did not isolate folate as a singular treatment for ear infections themselves.
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