Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Arch Dis Child. 2024 Jan 22;109(2):121-124. doi: 10.1136/archdischild-2023-325565.
To investigate the regular use of xylitol, compared with sorbitol, to prevent acute otitis media (AOM), upper respiratory tract infections (URTIs) and dental caries.
Blinded randomised controlled trial with a 6-month study period.
Enrolment took place at 11 primary care practices in Ontario, Canada.
Children aged 1-5 years who did not use xylitol or sorbitol at enrolment.
Children were randomly assigned to use a placebo syrup with sorbitol or xylitol syrup two times per day for 6 months.
Primary outcome was the number of clinician-diagnosed AOM episodes over 6 months. Secondary outcomes were caregiver-reported URTIs and dental caries.
Among the 250 randomised children, the mean (SD) age was 38±14 months and there were 124 girls (50%). There were three clinician-diagnosed AOM episodes in the 125 placebo group participants and six in the 125 xylitol group participants (OR 2.04; 95% CI 0.43, 12.92; p=0.50). There was no difference in number of caregiver-reported URTI episodes (rate ratio (RR) 0.88; 95% CI 0.70, 1.11) between the placebo (4.2 per participant over 6 months; 95% CI 3.6, 5.0) and xylitol (3.7; 95% CI 3.2, 4.4) groups. Dental caries were reported for four participants in the placebo group and two in the xylitol group (OR 0.42; 95% CI 0.04, 3.05; p=0.42). In a post-hoc analysis of URTIs during the COVID-19 pandemic, the rate among the 59 participants receiving placebo was 2.3 per participant over 6 months (95% CI 1.8, 3.0) and for the 55 receiving xylitol, 1.3 over 6 months (95% CI 0.92, 1.82; RR 0.56; 95% CI 0.36, 0.87). The most common adverse event was diarrhoea (28% with placebo; 34% with xylitol).
Regular use of xylitol did not prevent AOM, URTIs or dental caries in a trial with limited statistical power. A post-hoc analysis indicated that URTIs were less common with xylitol exposure during the COVID-19 pandemic, but this finding could be spurious.
NCT03055091.
研究木糖醇相对于山梨糖醇在预防急性中耳炎（AOM）、上呼吸道感染（URTI）和龋齿方面的常规使用。
为期 6 个月的盲法随机对照试验。
加拿大安大略省 11 个初级保健诊所进行入组。
入组时未使用木糖醇或山梨糖醇的 1-5 岁儿童。
儿童被随机分配每天使用安慰剂糖浆加山梨糖醇或木糖醇糖浆两次，持续 6 个月。
主要结局为 6 个月内临床诊断的 AOM 发作次数。次要结局为护理人员报告的 URTI 和龋齿。
在 250 名随机儿童中，平均（SD）年龄为 38±14 个月，有 124 名女孩（50%）。在 125 名安慰剂组参与者中，有 3 例临床诊断的 AOM 发作，在 125 名木糖醇组参与者中，有 6 例（比值比（OR）2.04；95%置信区间（CI）0.43，12.92；p=0.50）。在护理人员报告的 URTI 发作次数方面，安慰剂组（6 个月内每名参与者 4.2 次；95%CI 3.6，5.0）与木糖醇组（3.7；95%CI 3.2，4.4）之间没有差异（率比（RR）0.88；95%CI 0.70，1.11）。在安慰剂组中，有 4 名参与者报告了龋齿，在木糖醇组中有 2 名（OR 0.42；95%CI 0.04，3.05；p=0.42）。在 COVID-19 大流行期间 URTI 的事后分析中，接受安慰剂的 59 名参与者中，6 个月内每例参与者 URIT 发作率为 2.3 次（95%CI 1.8，3.0），而接受木糖醇的 55 名参与者中，6 个月内 URIT 发作率为 1.3 次（95%CI 0.92，1.82；RR 0.56；95%CI 0.36，0.87）。最常见的不良事件是腹泻（安慰剂组 28%；木糖醇组 34%）。
在一项统计能力有限的试验中，常规使用木糖醇并不能预防 AOM、URTI 或龋齿。事后分析表明，在 COVID-19 大流行期间，暴露于木糖醇时 URTI 较少，但这一发现可能是虚假的。
NCT03055091。
