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Who needs admission among infants with acute otitis media?

Mohamed A Bitar1, Rami Baz, Omar Sabra

  • 1Department of Otolaryngology Head and Neck Surgery, American University of Beirut School of Medicine and Medical Center, Beirut, Lebanon. mb36@aub.edu.lb

Journal of Paediatrics and Child Health
|November 24, 2011
PubMed

Insights

Management of acute otitis media in young infants is complex. Young infants with otitis media often require hospitalization and intravenous antibiotics, unlike older infants who may be treated as outpatients unless severely ill.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Management of acute otitis media (AOM) in infants under two months is debated.
  • Treatment approaches vary, including outpatient care versus hospitalization with intravenous antibiotics and sepsis work-up.
  • Pathogen variability in this age group contributes to management uncertainty.

Purpose of the Study:

  • To identify clinical indicators for invasive work-up or hospitalization in young infants with AOM.
  • To compare the management of young infants (under 2 months) with older infants with AOM.

Main Methods:

  • Retrospective chart review of infants with AOM over 20 years.
  • Categorization into 'young infants' (under 2 months) and 'older infants'.
  • Review of demographic data, history, physical exams, labs, and treatments.

Main Results:

  • Young admitted infants were less febrile and had less concerning white cell counts but more otorrhea (gram-negative organisms) than older inpatients.
  • Sepsis work-ups were negative in young infants.
  • Young infants were more likely to be admitted than older infants.

Conclusions:

  • Young infants frequently require admission for intravenous antibiotics pending middle ear cultures.
  • Sepsis work-up is reserved for toxic-appearing young infants.
  • Older infants are admitted for severe illness or complications.
Abstract

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