Acute Otitis Media in Children
Alexander K C Leung1, Alex H C Wong2
1The University of Calgary, Alberta Children's Hospital, #200, 233 - 16th Avenue NW, Calgary, Alberta. Canada.
Insights
Acute otitis media (AOM) is a common childhood infection. Antimicrobial treatment is recommended for most young children, but observation is an option for some older, healthy children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Otolaryngology
Background:
- Acute otitis media (AOM) is a prevalent childhood infection requiring prompt diagnosis and effective management.
- Understanding AOM's epidemiology and pathophysiology is crucial for pediatric care.
Purpose of the Study:
- To conduct an in-depth review of acute otitis media in children.
- Focus on epidemiology, pathophysiology, clinical presentation, diagnosis, complications, and treatment strategies.
Main Methods:
- Comprehensive PubMed search utilizing "acute otitis media" as the key term.
- Inclusion of patent searches from Google Patents, espacenet, and FreePatentsOnline for management innovations.
Main Results:
- AOM affects over 80% of children by age three, with recurrent episodes common.
- Key pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- Diagnosis relies on acute symptoms, middle ear inflammation, and effusion; treatment varies by age, laterality, and severity.
Conclusions:
- Antimicrobial therapy is advised for children under two, and for older children with specific severe symptoms or risk factors.
- Amoxicillin is the primary antibiotic choice.
- Observation without antibiotics is a viable option for select immunocompetent older children with uncomplicated AOM and reliable follow-up.
Background:
Acute otitis media is a common childhood infection. Prompt diagnosis and appropriate treatment are very important.
Objective:
To review in depth the epidemiology, pathophysiology, clinical manifestations, diagnosis, complications and particularly treatment of acute otitis media in children.
Methods:
A PubMed search was completed in Clinical Queries using the key term "acute otitis media". Patents were searched using the key term "acute otitis media" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com.
Results:
Acute otitis media affects over 80% of children before their third birthday and 30 to 45% of these children have suffered two or more episodes. Streptococcus pneumoniae, nontypable Haemophilus influenzae, and Moraxella catarrhalis are the most frequently isolated middle-ear pathogens. The diagnosis is based on acute onset of symptoms such as otalgia and fever, middle ear inflammation such as erythema of the tympanic membrane, and middle ear effusion. The choice of treatment method depends on the age of the child, laterality, and the severity of the disease. Recent patents related to the management of acute otitis media are also retrieved and discussed.
Conclusion:
Antimicrobial treatment is recommended for all children less than two years of age, as well as in children ≥ two years of age who have a temperature ≥ 39oC; are toxic looking; have otalgia > 48 hours; have bilateral otitis media or otorrhea; have craniofacial abnormalities; are immunocompromised; or have uncertain access to follow-up. Amoxicillin is the drug of choice. Observation without antibiotic is an option in immunocompetent children ≥ two years of age who have an acute uncomplicated otitis media and non-severe illness if appropriate follow-up can be arranged.
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