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Features predicting treatment failure in pediatric acute otitis media

Masamitsu Kono¹, Kunihiro Fukushima², Yosuke Kamide³

¹Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy

|August 24, 2020

Summary

Treatment failure in pediatric acute otitis media (AOM) was predicted by tympanic membrane and acute rhinosinusitis scores. These findings aid in discussing treatment decisions for AOM in children.

Area of Science:

Pediatric infectious diseases
Clinical pharmacology
Otolaryngology

Background:

Antibiotic stewardship is crucial for managing pediatric acute otitis media (AOM).
Identifying prognostic features of treatment failure can optimize antibiotic use.

Purpose of the Study:

To determine predictors of treatment failure in pediatric AOM.
To inform antibiotic stewardship strategies for AOM.

Main Methods:

A randomized, open-label trial enrolled children aged 1 month to 5 years with AOM.
Patients received amoxicillin alone or with clarithromycin.
Treatment success was evaluated using tympanic membrane scores and confirmed on day 14.

Main Results:

Treatment failure occurred in 19.4% of children.
Higher tympanic membrane and acute rhinosinusitis scores at days 3 and 5 predicted treatment failure.
Younger children (<2 years) had a higher failure rate.

Conclusions:

Tympanic membrane and acute rhinosinusitis scores on day 5 are significant predictors of AOM treatment failure.
These prognostic features can guide clinical decision-making and parental discussions regarding AOM treatment.

Keywords:

Acute otitis media Acute rhinosinusits Amoxicillin Prognosis Randomized clinical trial Tympanic membrane findings

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