scholarly journals Therapeutics for acute otitis media

2021 ◽  
Vol 64 (9) ◽  
pp. 624-630
Author(s):  
Junghun Kown ◽  
Juyong Chung
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Signs And Symptoms ◽  
Acute Onset ◽  
High Dose ◽  
Common Infectious Disease ◽  
Amoxicillin Clavulanate ◽  
Primary Care Clinicians

Background: Acute otitis media (AOM) is diagnosed in patients with acute onset of signs and symptoms of inflammation in the middle ear, accompanied by middle ear effusion. AOM is a common infectious disease in children, and its diagnosis and treatment can have significant impacts on the health of children.Current Concepts: The evidence-based clinical practice guidelines in Korea and other countries provide recommendations to primary care clinicians regarding the management of children with AOM. The treatment strategy for AOM depends on the patient’s age, severity of symptoms, the presence of otorrhea, and the laterality.Discussion and Conclusion: For children aged from 6-months to 2-years with unilateral non-severe AOM and children aged 2 years or older with unilateral or bilateral non-severe AOM, the published guidelines provide the option of observation rather than immediate treatment with antibiotics. High-dose amoxicillin (80 to 90 mg a day) is the firstline antibiotic for treating AOM in patients without penicillin allergies. Children in whom symptoms persist after 48 to 72 hours of antibiotic treatment should be re-examined and amoxicillin/clavulanate should be used as second-line antibiotics. Careful follow-up is required to identify the complications and sequelae of AOM, and to determine the optimum treatment.

Cefprozil versus high-dose amoxicillin/clavulanate in children with acute otitis media

2001 ◽  
Vol 23 (2) ◽  
pp. 193-204 ◽  
Author(s):  
James A. Hedrick ◽  
Lawrence D. Sher ◽  
Richard H. Schwartz ◽  
Phillip Pierce
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
High Dose ◽  
Amoxicillin Clavulanate

scholarly journals Prevalensi Otitis Media Akut di RS Islam Siti Rahmah Padang Tahun 2017

2019 ◽  
Vol 1 (1) ◽  
pp. 59-63
Author(s):  
Delpi Yuniarti ◽  
Seres Triola ◽  
Betty Fitriyasti
Keyword(s):  
Infectious Disease ◽  
Otitis Media ◽  
Middle Ear ◽  
Medical Records ◽  
Acute Inflammation ◽  
Acute Otitis Media ◽  
Secondary Data ◽  
Early Age ◽  
Research Subjects ◽  
Common Infectious Disease

Acute Otitis Media (OMA) is an acute inflammation of the middle ear that lasts less than three weeks. OMA is a common infectious disease at an early age and is a common reason for treatment. This infectious disease can be caused by many factors. This study aims to determine the prevalence of acute otitis media at Siti Rahmah Islamic Hospital in Padang. Method This type of research is descriptive retrospective using secondary data in the form of medical records. The study was conducted from July 2018 - January 2019 in the ENT section of the Siti Rahmah Islamic Hospital in Padang. The research subjects were 63 patients with Acute Otitis Media. This study reports the frequency distribution of research characteristics such as age, sex, stage, and infected ears. The result of this study report the prevalence of 63 patients with Acute Otitis Media. Based on age, the majority suffered at the age of five as many as 12 cases (19%). Based on gender, the majority of women suffered 35 cases (55.6%). Based on the stage, the most cases were at the stage of hyperemia 31 cases (49.2%). Based on the infected ear, the most cases were unilateral in 61 cases (96.8%). In this study the prevalence of acute otitis media in patients aged 0-5 years, female, hyperemic stage and unilateral infected ears were found.

Efficacy, tolerability, and parent reported outcomes for cefdinir vs. high-dose amoxicillin/clavulanate oral suspension for acute otitis media in young children

2006 ◽  
Vol 22 (9) ◽  
pp. 1839-1847 ◽  
Author(s):  
Stan L. Block ◽  
Jordana K. Schmier ◽  
Gerard F. Notario ◽  
Bolanle K. Akinlade ◽  
Todd A. Busman ◽  
...  
Keyword(s):  
Young Children ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Oral Suspension ◽  
High Dose ◽  
Amoxicillin Clavulanate

Workshop on Effects of Otitis Media on the Child

PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 639-652
Author(s):  
Charles D. Bluestone ◽  
Jerome O. Klein ◽  
Jack L. Paradise ◽  
Heinz Eichenwald ◽  
Fred H. Bess ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Current Knowledge ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Signs And Symptoms ◽  
Middle Ear Effusion ◽  
Ear Effusion

GOALS, DEFINITIONS, AND CLASSIFICATION OF OTITIS MEDIA —Charles D. Bluestone, MD The goal of this Workshop was to assess current knowledge concerning the effects of otitis media on the child. Experts in pediatrics, infectious disease, otolaryngology, audiology, speech, linguistics, and psychology met in Chicago on Aug 25, 1982 to participate in this Workshop. A summary of the discussions is presented here. Otitis media is broadly defined as an inflammation of the middle ear without reference to etiology or pathogenesis.1 Otitis media with effusion is an inflammation of the middle ear in which a collection of liquid (i.e., middle ear effusion) is present in the middle ear space (no perforation of the tympanic membrane is present). Atelectasis of the tympanic membrane, which may or may not be associated with otitis media, is defined as either collapse or retraction of the tympanic membrane. Acute otitis media implies a rapid and short onset of signs and symptoms lasting approximately 3 weeks. From 3 weeks to 3 months, the process may be resolving or subacute. If middle ear effusion persists beyond 3 months, the condition is classified as chronic otitis media with effusion. Many terms have been used for acute otitis media, such as "suppurative," "purulent," or "bacterial" otitis media; however, a "serous" effusion may also have an acute onset. Otitis media with effusion unaccompanied by signs and symptoms of acute inflammation has also had a plethora of other names: "serous," "secretory," "nonsuppurative," and "glue ear" have been the most commonly used. EPIDEMIOLOGY AND NATURAL HISTORY OF OTITIS MEDIA

Bacteriologic and clinical efficacy of high dose amoxicillin/clavulanate in children with acute otitis media

2001 ◽  
Vol 20 (9) ◽  
pp. 829-837 ◽  
Author(s):  
RON DAGAN ◽  
ALEJANDRO HOBERMAN ◽  
CANDICE JOHNSON ◽  
EUGENE L. LEIBOVITZ ◽  
ADRIANO ARGUEDAS ◽  
...  
Keyword(s):  
Otitis Media ◽  
Clinical Efficacy ◽  
Acute Otitis Media ◽  
High Dose ◽  
Amoxicillin Clavulanate

scholarly journals High-Dose Azithromycin versus High-Dose Amoxicillin-Clavulanate for Treatment of Children with Recurrent or Persistent Acute Otitis Media

2003 ◽  
Vol 47 (10) ◽  
pp. 3179-3186 ◽  
Author(s):  
Antonio Arrieta ◽  
Adriano Arguedas ◽  
Pilar Fernandez ◽  
Stan L. Block ◽  
Paz Emperanza ◽  
...  
Keyword(s):  
Otitis Media ◽  
Clinical Success ◽  
Acute Otitis Media ◽  
High Dose ◽  
Success Rates ◽  
Double Blind ◽  
Amoxicillin Clavulanate ◽  
Risk Patients ◽  
History Of ◽  
Intent To Treat

ABSTRACT Infants and young children, especially those in day care, are at risk for recurrent or persistent acute otitis media (AOM). There are no data on oral alternatives to high-dose amoxicillin-clavulanate for treating AOM in these high-risk patients. In this double-blind, double-dummy multicenter clinical trial, we compared a novel, high-dose azithromycin regimen with high-dose amoxicillin-clavulanate for treatment of children with recurrent or persistent AOM. Three hundred four children were randomized; 300 received either high-dose azithromycin (20 mg/kg of body weight once a day for 3 days) or high-dose amoxicillin-clavulanate (90 mg/kg divided twice a day for 10 days). Tympanocentesis was performed at baseline; clinical response was assessed at day 12 to 16 and day 28 to 32. Two-thirds of patients were aged ≤2 years. A history of recurrent, persistent, or recurrent plus persistent AOM was noted in 67, 18, and 14% of patients, respectively. Pathogens were isolated from 163 of 296 intent-to-treat patients (55%). At day 12 to 16, clinical success rates for azithromycin and amoxicillin-clavulanate were comparable for all patients (86 versus 84%, respectively) and for children aged ≤2 years (85 versus 79%, respectively). At day 28 to 32, clinical success rates for azithromycin were superior to those for amoxicillin-clavulanate for all patients (72 versus 61%, respectively; P = 0.047) and for those aged ≤2 years (68 versus 51%, respectively; P = 0.017). Per-pathogen clinical efficacy against Streptococcus pneumoniae and Haemophilus influenzae was comparable between the two regimens. The rates of treatment-related adverse events for azithromycin and amoxicillin-clavulanate were 32 and 42%, respectively (P = 0.095). Corresponding compliance rates were 99 and 93%, respectively (P = 0.018). These data demonstrate the efficacy and safety of high-dose azithromycin for treating recurrent or persistent AOM.

scholarly journals 2707. Non 13-Valent Pneumococcal Conjugate Vaccine Serotypes Predominate as Causes of Pneumococcal Otitis Media in Children

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S952-S952
Author(s):  
Kristina G Hulten ◽  
William J Barson ◽  
P Ling Lin ◽  
John S Bradley ◽  
Timothy R Peters ◽  
...  
Keyword(s):  
Otitis Media ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Standard Dose ◽  
Acute Otitis Media ◽  
High Dose ◽  
Vaccine Serotypes ◽  
Pediatr Infect ◽  
Susceptibility Data ◽  
Amoxicillin Clavulanate

Abstract Background Pneumococcal acute otitis media (AOM) in children due to vaccine-related serotypes (ST) has declined after the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), although some serotypes, such has 3, 19A and 19F have persisted. Among non-vaccine serotypes, 35B has been shown to contribute substantially to both OM and invasive infections. This study describes the current epidemiology of pneumococcal OM isolates obtained from the U S Pediatric Multicenter Pneumococcal Surveillance Group (USPMPSG). Methods From the USPMPSG database, we collected data from patients <18 years of age with pneumococcal OM isolates from 2014 to 2018. Analysis included demographics, immunization status, antimicrobial susceptibility data and serotype. Statistical comparisons included Fisher’s exact and Wilcoxon rank-sum tests. Results A total of 494 patients with isolates were identified within the time period from 5 children’s hospitals. Median age was 1.7 years (range 0–17.6) and 299 (60.5%) were male; 176 (35.7%) had an underlying condition. Thirty-two patients had received no dose of either PCV7 or PCV13. Thirty-five serotypes were identified (3 isolates were non-typeable), of which 6 serotypes [35B (16.8%), 3 (9.5%), 15A (7.9%), 15B (7.9%), 23B (7.9%) and 21 (6.1%)] caused more than half of the total OM infections (figure). Ninety (18.2%) isolates were of PCV13 serotypes. Twenty-five of 476 (5.3%) isolates had a penicillin MIC>2 µg/mL. These were of serotypes 11A, 15A/C, 19A/F, 35B and NT; 10/455 (2.2%) isolates had ceftriaxone MIC>1 µg/mL and were of ST 3, 15A, 19A/F and 35B. Conclusion Most pneumococcal OM were caused by non-PCV13 serotypes. Serotype 35B remained the most common serotype among pneumococcal isolates recovered from ear drainage or middle ear cultures. The low proportion of penicillin-resistant isolates along with the increasing proportion of AOM cases being due to non-pneumococcal isolates supports the consideration to switch routine antibiotic treatment for AOM to standard dose amoxicillin-clavulanate from high dose amoxicillin in PCV13 immunized children (Pediatr Infect Dis J 2018;37:1255–1257). Disclosures All authors: No reported disclosures.

Fever in a Child

2018 ◽  
pp. 277-280
Author(s):  
Shannon Drohan
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Watchful Waiting ◽  
Acute Otitis Media ◽  
Antibiotic Usage ◽  
Acute Illness ◽  
Middle Ear Effusion ◽  
Common Cause ◽  
Ear Effusion

Acute otitis media (AOM) is a common cause of fever especially in the first two years of life. This condition can be easily diagnosed in a child with an acute illness by presence of middle ear effusion on exam in addition to signs of inflammation revealed by intense erythema or report of otalgia. Recent guidelines recommend a “watchful waiting” approach to treatment in certain patients to help reduce antibiotic usage as most cases of AOM resolve spontaneously. This strategy can be used in children >6 months old with non-severe symptoms, as long as follow-up is ensured to provide a rescue antibiotic if symptoms do not improve within 48-72 hours.

Theoretical Cost Effectiveness of Management Options for Children With Persisting Middle Ear Effusions

PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 353-363 ◽  
Author(s):  
Stephen Berman ◽  
Robert Roark ◽  
Dennis Luckey
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Private Practice ◽  
Acute Otitis Media ◽  
Cost Effective ◽  
Medicaid Reimbursement ◽  
Cost Effective Approach ◽  
Ventilating Tubes ◽  
The Difference

Objective. The purpose of this theoretical study is to assess the cost effectiveness of options involving observation, antibiotics alone, corticosteroids alone, corticosteroids plus antibiotics, and surgery to clear persisting middle ear effusions during three visits. Methodology. In a hypothetical case the expected average per patient expenditures are calculated using the efficacy rates determined by the meta-analysis of randomized controlled clinical trials involving corticosteroids plus an antibiotic (six trials), corticosteroids alone (three trials), and antibiotic alone (four trials). In this analysis, all children whose bilateral middle ear effusions persist for 12 weeks despite medical management are referred for ventilating tubes. Results. The most cost-effective intervention combination is corticosteroid plus an antibiotic at visit 1 (6 weeks after diagnosis of acute otitis media) followed by a second antibiotic in nonresponders at visit 2 (9 weeks after diagnosis of acute otitis media) and referral for ventilating tubes in nonresponders at visit 3 (12 weeks after diagnosis of acute otitis media). The expected average expenditures per case to clear the bilateral middle ear effusions is $600.91 based on reimbursement of private practice charges and $350.27 based on Medicaid reimbursement (all payments to providers are based on 1992 data from Colorado). The difference in the expected average total expenditures per case between this most cost-effective approach versus the use of sequential courses of antibiotics followed by surgery is $372.81 ($973.72 - $600.91) with full reimbursement of private practice charges and $202.57 ($552.84 - $350.27) with Medicaid re imbursement. In clearing the middle ear effusion, the average estimated travel expenses per case is $21.46, and lost parental wages per case are $45.12. When the expenditures associated with an additional 6-month follow-up period are included, the expected average per case expenditures is $1088.54 with reimbursement of private practice charges and $659.00 with Medicaid reimbursement. The difference in the expected average per case expenditures to clear the effusions and follow-up for 6 months between the most cost-effective approach using corticosteroids plus antibiotics at the 6- and 9-week visits followed by surgery in nonresponders at 12 weeks versus sequential courses of antibiotics is $405.30 ($1493.84 - $1088.54) with reimbursement of private practice charges and $217.32 ($876.32 - $659.00) with Medicaid reimbursement. Recommendations. Although the analysis does not consider risks, side effects, and parental or provider preferences, the findings suggest that the implementation of cost-effective clinical guidelines can potentially reduce national expenditures for managing persistent middle ear effusions.

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