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Otitis media: diagnosis and treatment
Kathryn M Harmes1, R Alexander Blackwood, Heather L Burrows
1University of Michigan, Ann Arbor, MI, USA.
American Family Physician
|October 19, 2013
Summary
Acute otitis media (AOM) is an ear infection diagnosed by acute onset, middle ear effusion, and inflammation. Management includes analgesia, with antibiotics reserved for specific cases, and amoxicillin as the first choice.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Acute otitis media (AOM) commonly follows viral upper respiratory infections, leading to eustachian tube dysfunction.
- Key pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- Diagnosis relies on acute onset, middle ear effusion, and physical signs of inflammation.
Purpose of the Study:
- To outline diagnostic criteria for acute otitis media.
- To detail recommended management strategies for AOM.
- To differentiate AOM from otitis media with effusion (OME).
Main Methods:
- Clinical diagnosis based on patient symptoms (pain, fever, irritability) and physical examination findings.
- Microbiological analysis of middle ear fluid to identify causative organisms.
- Treatment guidelines based on patient age, symptom severity, and response to therapy.
Main Results:
- Amoxicillin (80-90 mg/kg/day) is the preferred antibiotic for penicillin-allergic patients.
- Antibiotic therapy can be delayed in children over two years with mild symptoms.
- Amoxicillin/clavulanate is a suitable second-line option for persistent symptoms.
Conclusions:
- Prompt analgesia is crucial for AOM symptom management.
- Otitis media with effusion (OME) requires no antibiotic treatment.
- Referral to an otolaryngologist is recommended for children with complications like hearing loss or language delay.
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