scholarly journals TIMING OF RE-EVALUATION FOR INITIAL FOLLOW-UP VISIT (FUV) FOR ACUTE OTITIS MEDIA WITH EFFUSION (AOME): A RANDOMIZED COMPARATIVE STUDY OF 10 DAYS vs 30 DAYS

1984 ◽  
Vol 18 ◽  
pp. 233A-233A
Author(s):  
Richard H Schwartz ◽  
Wm J Rodriguez ◽  
Kenneth M Grundfast
Keyword(s):  
Comparative Study ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media

The follow up of Acute Otitis Media general practice

1995 ◽  
Vol 81 (2) ◽  
pp. 127-134
Author(s):  
A P Newton
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Care Team ◽  
Primary Care Team ◽  
Common Condition ◽  
Glue Ear

AbstractAcute Otitis Media is a common condition of childhood which potentially has a number of significant sequelae including the development of Otitis Media with Effusion (‘Glue Ear’). A general practice based study is described which assesses the implementation of a protocol for the follow up of Acute Otitis Media by the primary care team. The results of this study show that following the introduction of a follow up protocol a significantly improved rate of followup was achieved with resultant improvements in the identification of ‘Glue Ear’ and hence more appropriate referral for ENT care.

Consultation with the Specialist

1992 ◽  
Vol 13 (1) ◽  
pp. 23-24
Author(s):  
Gerald B. Healy
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Disease Process ◽  
Care Physician ◽  
Ear Canal ◽  
Patient Groups ◽  
Partially Occluded

Otitis media with effusion (OME) offers the primary care physician both a diagnostic and a therapeutic challenge. The tympanic membrane of a child frequently is difficult to assess, especially in the uncooperative patient whose ear canal is partially occluded by cerumen. However, if the ear canal can be cleared to allow an unobscured view of the tympanic membrane, then pneumatic otoscopy and tympanometry can be extremely valuable in both the diagnosis and follow-up after initiation of treatment. Patient Groups The pediatrician usually is faced with two groups of patients in this disease process. The first group includes the young child who has recurrent episodes of acute otitis media. Frequently, affected patients can be subdivided into those who clear their middle ear space of fluid between episodes and those who do not. The second group consists of children who have asymptomatic chronic effusion, usually leading to persistent hearing loss. These children tend to be slightly older but are no less troublesome for the clinician. Treatment Controlled clinical trials have been extremely important in providing information about both of these groups. These studies have shown that chemoprophylaxis is extremely useful in managing the patient who has recurring acute suppurative episodes not complicated by persistent effusion during the interval periods.

scholarly journals Association of Receipt of Antibiotics with Patient Satisfaction for Caregivers of Children Presenting to Urgent-Care Settings

2020 ◽  
Vol 41 (S1) ◽  
pp. s134-s135
Author(s):  
Diane Liu ◽  
NORA FINO ◽  
Benjamin Haaland ◽  
Adam Hersh ◽  
Emily Thorell ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Otitis Media ◽  
Respiratory Infections ◽  
Otitis Media With Effusion ◽  
Multivariable Analysis ◽  
Acute Otitis Media ◽  
Skewed Distribution ◽  
Urgent Care ◽  
Provider Type ◽  
Patient Dissatisfaction

Background: The Press Ganey (PG) Medical Practice Survey is a commonly used questionnaire for measuring patient experience in healthcare. Our objective was to evaluate the PG surveys completed by caregivers of children presenting for urgent care evaluation of acute respiratory infections (ARIs) to determine any correlation with receipt of antibiotics during their visit. Methods: We evaluated responses to the PG urgent-care surveys for encounters of children <18 years presenting with ARIs (ie, sinusitis, bronchitis, pharyngitis, upper respiratory infection, acute otitis media, or serous otitis media with effusion) within 9 University of Utah urgent-care centers. Scores could range from 0 to 100. Because the distributions of scores followed right- skewed distribution with a high ceiling effect, we defined scores as dissatisfied with their care (≤25th percentile) and satisfied with their care (scores >25th percentile). Univariate and multivariable generalized mixed-effects logistic regression was used to assess correlates of patient dissatisfaction. Random intercepts were included for each provider to account for correlation within the same provider. Separate models were used for each PG component score. Multivariable models adjusted for receipt of antibiotics, age, gender, race, ethnicity, and provider type. Results: Overall, 388 of 520 responses (74.6%) indicated satisfaction and 132 responses (25.4%) indicated dissatisfaction. Among patients who did not receive antibiotics, 87 of 284 responses (30.6%) indicated dissatisfaction versus 45 of 236 (19.1%) who did receive antibiotics. Among patients who were dissatisfied with their clinician, raw clinician PG scores were higher among patients who received antibiotics (mean, 64.5; standard deviation [SD], 16.9) versus those who did not receive antibiotics (mean, 54.7; SD, 24.4; P = .015) (Table 1). In a multivariable analysis, receipt of antibiotics was associated with a reduction in patient dissatisfaction overall (odds ratio, 0.55; 95% CI, 0.36–0.85). Conclusions: Overall, most responses for patients seen for ARIs in pediatric urgent care were satisfied. However, a significantly higher proportion of responses for patients who did not receive antibiotics were dissatisfied than for those patients who received antibiotics. Antibiotic stewardship strategies to communicate appropriate prescribing while preserving patient satisfaction are needed in pediatric urgent-care settings.Funding: NoneDisclosures: None

scholarly journals Otitis media outcomes of a combined 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine and 13-valent pneumococcal conjugate vaccine schedule at 1-2-4-6 months: PREVIX_COMBO, a 3-arm randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Jane Leach ◽  
Edward Kim Mulholland ◽  
Mathuram Santosham ◽  
Paul John Torzillo ◽  
Peter McIntyre ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Conjugate Vaccine ◽  
Otitis Media With Effusion ◽  
Controlled Trial ◽  
Acute Otitis Media ◽  
Trial Registration ◽  
Open Label ◽  
Suppurative Otitis Media ◽  
Link Type

Abstract Background Aboriginal children living in Australian remote communities are at high risk of early and persistent otitis media, hearing loss, and social disadvantage. Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the primary pathogens. We compared otitis media outcomes in infants randomised to either a combination of Synflorix™ (PHiD-CV10, with protein D of NTHi) and Prevenar13™ (PCV13, with 3, 6A, and 19A), with recommended schedules for each vaccine alone. We previously reported superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months. Methods In an open-label superiority trial, we randomised (1:1:1) Aboriginal infants at 28 to 38 days of age, to either Prevenar13™ (P) at 2–4-6 months (_PPP), Synflorix™ (S) at 2–4-6 months (_SSS), or Synflorix™ at 1–2-4 months plus Prevenar13™ at 6 months (SSSP). Ears were assessed using tympanometry at 1 and 2 months, combined with otoscopy at 4, 6, and 7 months. A worst ear diagnosis was made for each child visit according to a severity hierarchy of normal, otitis media with effusion (OME), acute otitis media without perforation (AOMwoP), AOM with perforation (AOMwiP), and chronic suppurative otitis media (CSOM). Results Between September 2011 and September 2017, 425 infants were allocated to _PPP(143), _SSS(141) or SSSP(141). Ear assessments were successful in 96% scheduled visits. At 7 months prevalence of any OM was 91, 86, and 90% in the _PPP, _SSS, and SSSP groups, respectively. There were no significant differences in prevalence of any form of otitis media between vaccine groups at any age. Combined group prevalence of any OM was 43, 57, 82, 87, and 89% at 1, 2, 4, 6, and 7 months of age, respectively. Of 388 infants with ear assessments at 4, 6 and 7 months, 277 (71.4%) had OM that met criteria for specialist referral; rAOM, pOME, or CSOM. Conclusions Despite superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months, there were no significant differences in prevalence of otitis media nor healthy ears throughout the first months of life. Trial registration ACTRN12610000544077 registered 06/07/2010 and ClinicalTrials.govNCT01174849 registered 04/08/2010.

The acceptance of hearing aids for children with otitis media with effusion

1999 ◽  
Vol 113 (4) ◽  
pp. 314-317 ◽  
Author(s):  
A. H. Jardine ◽  
M. V. Griffiths ◽  
E. Midgley
Keyword(s):  
Otitis Media ◽  
Hearing Aids ◽  
Otitis Media With Effusion ◽  
Binaural Hearing ◽  
Long Term Effects ◽  
Non Invasive ◽  
Parents And Children ◽  
Binaural Hearing Aids

AbstractConservative treatment for otitis media with effusion (OME) led us to consider the use of hearing aids as a way of managing the associated hearing loss. This study aimed to assess the compliance of patients and acceptance of hearing aids for the management of children with OME.Thirty-nine children who had been given binaural hearing aids to manage OME were assessed at routine follow-up after six months. A clinician who did not prescribe the aid administered a questionnaire to assess compliance, change in symptoms and acceptance of the aids.Thirty-eight parents thought the aids were easy to use and 25 (66 per cent) were completely satisfied with the management. Aided hearing improved by a mean of 17 dB (Range 10–30) over three frequencies, 0.5, 1.0, 2.0 Khz and all parents reported subjective hearing improvement in their children. The stigma of an aid was reported as minimal under the age of seven.Hearing aids provide a non-invasive way of managing the problems associated with OME which is acceptable to certain parents and children. Long-term effects of using aids need to be evaluated before they can be recommended.

Otitis Media in Infancy: Tympanometric Findings

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
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Normal Pressure ◽  
Pressure Curve ◽  
Type B ◽  
History Of ◽  
Life Type ◽  
Insight Into

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.

Otitis Media

PEDIATRICS ◽  
1984 ◽  
Vol 74 (5) ◽  
pp. 948-949
Author(s):  
Charles M. Ginsburg
Keyword(s):  
Otitis Media ◽  
Viral Infections ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Medical Personnel ◽  
Medical Attention ◽  
Common Symptom ◽  
Upper Respiratory Tract ◽  
Primary Responsibility ◽  
Printed Materials

Earache, a common symptom in children, causes many parents to seek medical attention. Aside from trauma and the discomfort that often accompanies viral infections of the upper respiratory tract, acute otitis media with effusion is the commonest cause of otalgia in infants and children. Proper management requires a team effort between the physician and the child's parents or caretaker. The physician must transmit to the parents a concise but thorough overview of the problem and a plan for management. This should include information on the pathophysiology of ear disease, its incidence, therapy and the potential adverse effects, and any measures that the parents may take to prevent recurrence. The primary responsibility for transmittal of this information lies with the physician. Ancillary medical personnel and communication aids (videotapes, computers, printed materials) should be utilized, if available, to reinforce the physician's "message.'

Comparison of Cefpodoxime Proxetil and Cefixime in the Treatment of Acute Otitis Media in Infants and Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 847-852
Author(s):  
Basim I. Asmar ◽  
Adnan S. Dajani ◽  
Mark A. Del Beccaro ◽  
Paul M. Mendelman ◽  
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Drug Efficacy ◽  
Oral Suspension ◽  
Suppurative Otitis Media ◽  
Once Daily ◽  
Cefpodoxime Proxetil ◽  
Long Term Follow Up ◽  
Cure Rates

Objective. To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media. Design. Randomized, multicenter, investigator-blinded. Setting. Outpatient. Patients. A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxime or cefixime in a 2:1 ratio (245 cefpodoxime, 123 cefixime); 236 patients (155 cefpodoxime, 81 cefixime) were evaluable for drug efficacy. Interventions. Patients received either cefpodoxime proxetil oral suspension (10 mg/kg/day, once daily for 10 days) or cefixime oral suspension (8 mg/kg/day, once daily for 10 days). Main outcome measures. Clinical evaluations were performed before treatment (study day 1), at an interim visit (study day 3 through 6), at the end of therapy (study day 12 through 15), and at final follow-up (study day 25 through 38). Microbiologic evaluations were performed at enrollment and whenever appropriate thereafter. Results. End-of-therapy clinical cure rates in evaluable patients were 56% for the cefpodoxime group and 54% for the cefixime group. Clinical improvement rates were 27% for both groups. Clinical response rates were not significantly different between treatment groups (P = .541; 95% confidence interval = -8.1%, 15.2%). At long-term follow-up, 17% of patients in the cefpodoxime group and 20% in the cefixime group had a recurrence of infection. Drug-related adverse events (eg, diarrhea, diaper rash, vomiting, rash) occurred in 23.3% of cefpodoxime-treated patients and 17.9% of cefixime-treated patients (P = .282). Conclusions. These findings suggest that cefpo-doxime proxetil administered once daily is as effective and safe as cefixime given once daily in the treatment of acute suppurative otitis media in pediatric patients.

scholarly journals Comparative study of once-weekly azithromycin and once-daily amoxicillin treatments in prevention of recurrent acute otitis media in children.

1996 ◽  
Vol 40 (12) ◽  
pp. 2732-2736 ◽  
Author(s):  
P Marchisio ◽  
N Principi ◽  
E Sala ◽  
L Lanzoni ◽  
S Sorella ◽  
...  
Keyword(s):  
Otitis Media ◽  
Randomized Study ◽  
Acute Otitis Media ◽  
Occurrence Rate ◽  
Once Daily ◽  
Recurrent Acute Otitis Media ◽  
Periodic Administration ◽  
Resistant Strains ◽  
Selection Of

Continuous chemoprophylaxis is effective in the prevention of new episodes of acute otitis media (AOM) in otitis-prone children, but compliance can be a problem and thus efficacy can be decreased. Intermittent chemoprophylaxis has so far shown conflicting results. Azithromycin, which has a peculiar pharmacokinetics, resulting, even after a single dose, in persistently elevated concentrations in respiratory tissues, could permit a periodic administration with higher compliance. We compared a 6-month course of once-weekly azithromycin (5 or 10 mg/kg of body weight) with that of once-daily amoxicillin (20 mg/kg) in a single-blind, randomized study of prophylaxis for recurrent AOM in 159 children aged 6 months to 5 years with at least three episodes of AOM in the preceding 6 months. In the amoxicillin group, 23 (31.1%) of 74 children developed 29 episodes of AOM, while in the 10-mg/kg azithromycin group, 11 (14.9%) of 74 children experienced 15 episodes. The 5-mg/kg/week azithromycin trial was prematurely interrupted after nine cases, due to the high occurrence rate of AOM (55.5%). During the 6-month prophylaxis period, the proportion of children with middle ear effusion declined similarly in both groups. No substantial modification of the nasopharyngeal flora was noted at the end of prophylaxis in both antimicrobial groups. In the 6-month-postprophylaxis follow-up period, about 40% of children in both groups again developed AOM. Azithromycin at 10 mg/kg once weekly can be regarded as a valid alternative to once-daily low-dose amoxicillin for the prophylaxis of AOM. Although in the present study no microbiological drawback was noted, accurate selection of children eligible for prophylaxis is mandatory to avoid the risk of emergence of resistant strains.

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