GC–MS-Based Correlation Study of Clinical and Metabolomic Effects of Anise Essential Oil in Almond Oil as Adjunct Therapy for Recurrent Acute Suppurative Otitis Media in Early Childhood

Acute suppurative otitis media (ASOM) is a common infectious disease affecting children aged 6–36 months. The growing problem of antimicrobial resistance and the occurrence of hypersensitivity reactions highlight the need for safe and effective adjunctive treatment options. This study aimed to assess the clinical effectiveness and metabolomic impact, based on volatile organic compound (VOC) biomarkers, of a 1% anise essential oil extract diluted in almond oil when used as an adjunct therapy in ASOM. A prospective controlled study was conducted involving 48 pediatric patients divided into two groups: a control group receiving standard therapy and an experimental group receiving standard therapy combined with an anise oil mixture. Clinical parameters, including the CHEOPS score, body temperature, otoscopic findings, and exudate volume, together with VOC profiling using gas chromatography–mass spectrometry (GC-MS), were evaluated before and after treatment. In the experimental group, VOC biomarkers associated with Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Haemophilus influenzae, and anaerobic bacteria decreased by 60–90%, compared with a 30–50% reduction in the control group. Clinical recovery was observed 2–2.5 days earlier in the experimental group. Correlation analysis demonstrated strong inverse relationships between the CHEOPS score and phenylethanol (R = −0.78), body temperature and short-chain fatty acids (R = −0.82), and otoscopic score and 2,3-butanediol (R = −0.74). The addition of anise oil diluted in almond oil significantly enhanced the rate of clinical recovery and reduced pathogenic VOC activity, supporting its antimicrobial and anti-inflammatory synergistic effects. GC-MS-based VOC profiling appears to be a valuable approach for the early prediction of treatment outcomes.