Antimicrobial Treatment of Acute Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 11-14 ◽  
Author(s):  
Daniel M. Canafax ◽  
G. Scott Giebink

Episodes of acute otitis media frequently occur in childhood and are attended by significant morbidity, such as hearing loss and possible speech delay. Bacteria play an important etiologic role in the pathogenesis of otitis media; therefore, antimicrobial agents are the cornerstone in the treatment of this disease. Many antimicrobial choices are available for treating children with acute otitis media. To choose an antimicrobial for each patient, consideration must be given to the patient's age, history of otitis media episodes, and responses to previously used antimicrobial drugs, and the regional antimicrobial susceptibility of the otitis media pathogens.

1992 ◽  
Vol 101 (1_suppl) ◽  
pp. 21-23 ◽  
Author(s):  
G. Scott Giebink

Otitis media primarily affects children, but can also lead to lifelong sequelae. Middle ear histopathologic changes and clinical manifestations can represent any part of a disease continuum, from acute to recurrent to chronic otitis media. Acute otitis media is most often caused by an acute respiratory viral infection and secondary replication of bacteria in the middle ear space and tissues, leading to symptoms and signs of infection (ie, fever, pain, tympanic membrane erythema). Antimicrobial therapy is the mainstay of management, and clinical response to different antimicrobial drugs appears to be similar. The bacteriologic efficacy of these drugs, however, is quite variable. Clearly, antimicrobial treatment of acute otitis media, which currently is largely empiric, must be fine-tuned on the basis of patient and disease variation.


Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 52
Author(s):  
Elena Lia Spoială ◽  
Gabriela Dumitrita Stanciu ◽  
Veronica Bild ◽  
Daniela Carmen Ababei ◽  
Cristina Gavrilovici

Acute otitis media (AOM) in children represents a public health concern, being one of the leading causes of health care visits and antibiotic prescriptions worldwide. The overall aim of this paper is to unravel the major current insights into the antibiotic treatment of AOM in children. Our approach is three-fold: 1. a preclinical evaluation of antibiotics in animal models of AOM stressing on the advantages of different species when testing for different schemes of antibiotics; 2. an overview on the new antimicrobial agents whose efficacy has been demonstrated in refractory cases of AOM in children; and 3. an analysis of the different guidelines stressing on the differences and similarities between the various schemes of antibiotic treatment. The preferred therapeutic agents remain amoxicillin and the amoxicillin-clavulanate combination for AOM caused by Streptococcus pneumoniae, whereas oral cephalosporin is preferred in AOM due to Moraxella catarrhalis and Haemophilus influenzae. As for the second and third line antimicrobial treatments, there is a wide variety of suggested antibiotic classes with variations in duration and posology. The decision to prescribe antimicrobial treatment as a first-line choice is based on the severity of the symptoms in 16 of the guidelines included in this review.


2004 ◽  
Vol 53 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Gunnsteinn Haraldsson ◽  
W. Peter Holbrook ◽  
Eija Könönen

The environment of an infant's nasopharynx during acute otitis media (AOM) favours the growth of anaerobic bacteria, which can be recovered frequently during infection, but hardly at all if the infant is healthy. The aim of this investigation was to identify the potential source and inoculation route of anaerobes that were present in the nasopharynx. Eleven Fusobacterium nucleatum isolates that were collected through the nasal cavity from the nasopharynx of eight infants with a history of AOM, and 161 F. nucleatum isolates from the saliva of the same infants, were typed to the clonal level by using arbitrarily primed PCR (AP-PCR). In five of the eight infants examined, identical AP-PCR types were found among nasopharyngeal and salivary isolates. As anaerobes seem to be present only transiently in the nasopharynx and salivary contamination of the nasopharyngeal samples can be excluded, this observation indicates that the source of nasopharyngeal anaerobes is the oral cavity and that saliva is their transmission vehicle.


PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 435-442
Author(s):  
Jessie R. Groothuis ◽  
Sarah H. W. Sell ◽  
Peter F. Wright ◽  
Judith M. Thompson ◽  
William A. Altemeier

Ninety-one normal infants were followed longitudinally for varying periods from November 1975 to April 1977 to assess the correlation between tympanometry and pneumatic otoscopy and to study the pathogenesis of acute and chronic otitis media early in life. Type A (normal) tympanograms correlated with normal otoscopic findings in 92% of instances. Type B tympanograms, indicating reduced drum compliance with a relatively flat pressure curve, were associated with abnormal otoscopic findings in 93% of cases. The A8 (reduced compliance, normal pressure) and C (normal compliance, negative pressure) tympanograms were less consistent predictors of otoscopic findings. The correlation of tympanometric and otoscopic findings were similar in infants above and below 7 months of age. Tympanometry provided some insight into the natural history of otitis in 71 infants followed 12 to 17 months. Infants who failed to develop otitis had type B curves in only one of 240 determinations (0.4%). This pattern did not appear in those who developed acute otitis media (AOM) until the month preceding the first attack; nine of 29 tests (31%) made under these circumstances were type B. When a type B curve appeared in an asymptomatic study infant who had not previously had otitis, AOM developed within a month in nine of ten instances. At the time of diagnosis of first AOM, 87% of tympanograms were type B with the remainder type A8 or C. Sixty-three percent of tympanograms obtained from 25 infants during the six months following first AOM were type B, indicating that abnormal middle ear function was often prolonged. Fifteen of these 25 developed recurrent otitis during follow-up.


PEDIATRICS ◽  
1974 ◽  
Vol 53 (2) ◽  
pp. 135-136
Author(s):  
Patrick Manning ◽  
Mary Ellen Avery ◽  
Alan Ross

The paper by Kaplan and colleagues in a previous issue starts by emphasizing the unusually high incidence of otitis media among Eskimo children. Forty-one percent of their cohort of 489 Alaskan Eskimo children, followed for ten years, had perforations or scars of the tympanic membranes; significant hearing losses were present in 16% of the group. Among the 374 children with a history of otorrhea, 291 (78%) had their first attack before their second birthday. The adverse effects of hearing loss in early life on language development were underscored by the authors, who quite properly point out the need for special educational programs.


PEDIATRICS ◽  
1973 ◽  
Vol 52 (4) ◽  
pp. 577-585 ◽  
Author(s):  
Gary J. Kaplan ◽  
J. Kenneth Fleshman ◽  
Thomas R. Bender ◽  
Carol Baum ◽  
Paul S. Clark

Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children who have been followed through the first ten years of life. Seventy-six per cent had experienced one or more episodes of otitis media since birth. Of these, 78% had their first attack during their first two years of life. Perforations and scars were present in 41%. A hearing loss of 26 decibels or greater was present in 16%, and an additional 25% were in the normal range but had a measurable air-bone gap. Children with a history of otitis media prior to 2 years of age and a hearing loss of 26 decibels or greater had a statistically significant loss of verbal ability and were behind in total reading, total math, and language. In addition, children who had an early onset of otitis media but now had normal hearing with a conductive component were also adversely affected in verbal areas. The number of otitis media episodes was related to tympanic membrane abnormalities, hearing loss, and low verbal and achievement scores. These findings indicate that otitis media has been a significant cause of morbidity in Alaskan Eskimo children, and its onset during the critical years of language development as well as the number of episodes play an important role in impairing verbal development.


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