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Update on acute otitis media
Sharon E. Balter1, Scott F. Dowell
1aEpidemiology and Surveillance Division, National Immunization Program, and bRespiratory Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Abstract:
The increase in drug-resistant Streptococcus pneumoniae has led to concerns about antibiotic resistance. Otitis media is the leading indication for antibiotic use in the United States. Evidence suggests that antibiotics do provide benefit to children with documented acute otitis media, and that carefully selected children may respond to shorter courses of antibiotics. Despite the increase in resistance, amoxicillin remains the drug of choice for acute otitis media even in areas with high levels of resistance. Pneumococcal conjugate vaccine and live attenuated influenza vaccine, which may be licensed in the future, will both have an impact on acute otitis media. During the next few years, these vaccines, along with more stringent diagnostic criteria, and more judicious use of antibiotics, may all contribute towards reducing the incidence of acute otitis media, the number of antibiotic prescriptions given and the adverse impact of antimicrobial resistance.
Insights
Antibiotic resistance is a growing concern, especially for Streptococcus pneumoniae. New vaccines and careful antibiotic use may reduce acute otitis media incidence and prescriptions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Increasing antibiotic resistance in Streptococcus pneumoniae raises significant public health concerns.
- Otitis media represents the primary reason for antibiotic prescriptions in children within the United States.
- While antibiotics offer benefits for acute otitis media, shorter courses may suffice for select pediatric patients.
Purpose of the Study:
- To review the current landscape of antibiotic use for acute otitis media.
- To discuss the impact of emerging vaccines on otitis media management.
- To explore strategies for reducing antibiotic prescriptions and mitigating antimicrobial resistance.
Main Methods:
- Literature review of studies on Streptococcus pneumoniae resistance and otitis media treatment.
- Analysis of antibiotic efficacy and resistance patterns.
- Evaluation of the potential impact of novel vaccines and diagnostic criteria.
Main Results:
- Amoxicillin remains the primary antibiotic choice for acute otitis media, even with high resistance levels.
- Evidence supports the efficacy of antibiotics for acute otitis media, with potential for shorter treatment durations.
- Upcoming vaccines (pneumococcal conjugate and live attenuated influenza) are expected to influence otitis media incidence.
Conclusions:
- Future reductions in acute otitis media incidence and antibiotic prescriptions are anticipated.
- Vaccination, refined diagnostic standards, and judicious antibiotic stewardship are key to combating antimicrobial resistance.
- A multi-faceted approach is necessary to address the challenges posed by drug-resistant Streptococcus pneumoniae and otitis media.