Abstract
Otitis media is among the most commonly diagnosed diseases in children presenting to physicians' offices.1 It accounts for millions of dollars of healthcare costs annually, and accounts for more than half of all pediatric antibiotic prescriptions annually.2 The management of otitis media in the primary care setting has become more complicated in recent years, despite the introduction of vaccines that have decreased complications of the disease. Rising healthcare costs, increasing antibiotic resistance, and changing parental expectations all play a role in the process. In 2004, The American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) released guidelines for the diagnosis and treatment of otitis media to attempt to simplify disease management.3 This chapter addresses epidemiology, risk factors, and pathogenesis of acute otitis media (AOM), and focuses on the diagnosis and treatment strategies currently recommended in the 2004 AAP/AAFP guidelines.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Dowell SF, Schwartz B, Phillips WR. Appropriate use of antibiotics for URIs in children: Part I. Otitis media and acute sinusitis. The Pediatric URI Consensus Team. Am Fam Physician. 1998 Oct 1;58(5):1113–1118, 1123.
Berman S, Byrns PJ, Bondy J, Smith PJ, Lezotte D. Otitis media-related antibiotic prescribing patterns, outcomes, and expenditures in a pediatric medicaid population. Pediatrics. 1997 Oct;100(4):585–592.
American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004 May;113(5):1451–1465.
Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989 Jul;160(1):83–94.
Lanphear BP, Byrd RS, Auinger P, Hall CB. Increasing prevalence of recurrent otitis media among children in the United States. Pediatrics. 1997 Mar;99(3):E1.
Rovers MM, Zielhuis GA, Ingels K, van der Wilt GJ. Day-care and otitis media in young children: a critical overview. Eur J Pediatr. 1999 Jan;158(1):1–6.
Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med. 2004 Nov 8;164(20):2206–2216.
Uhari M, Mantysaari K, Niemela M. A meta-analytic review of the risk factors for acute otitis media. Clin Infect Dis. 1996 Jun;22(6):1079–1083.
Rovers MM, Schilder AG, Zielhuis GA, Rosenfeld RM. Otitis media. Lancet. 2004 Feb 7;363(9407):465–473.
Grijalva CG, Poehling KA, Nuorti JP, Zhu Y, Martin SW, Edwards KM, Griffin MR. National impact of universal childhood immunization with pneumococcal conjugate vaccine on outpatient medical care visits in the United States. Pediatrics. 2006 Sep;118(3):865–873.
Bluestone CD, Stephenson JS, Martin LM. Ten-year review of otitis media pathogens. Pediatr Infect Dis J. 1992 Aug;11(8 Suppl):S7–11.
Niemela M, Uhari M, Jounio-Ervasti K, Luotonen J, Alho OP, Vierimaa E. Lack of specific symptomatology in children with acute otitis media. Pediatr Infect Dis J. 1994 Sep;13(9):765–768.
Kontiokari T, Koivunen P, Niemela M, Pokka T, Uhari M. Symptoms of acute otitis media. Pediatr Infect Dis J. 1998 Aug;17(8):676–679.
Pellman H. Thoughts on the American Academy of Pediatrics/American Academy of Family Physicians clinical practice guideline on acute otitis media: a different perspective. Pediatrics. 2005 May;115(5):1443–1444.
Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003 Oct;113(10):1645–1657.
Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED. Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial. JAMA. 2006 Sep 13;296(10):1235–1241.
Siegel RM, Kiely M, Bien JP, Joseph EC, Davis JB, Mendel SG, Pestian JP, DeWitt TG. Treatment of otitis media with observation and a safety-net antibiotic prescription. Pediatrics. 2003 Sep;112(3 Pt 1):527–531.
Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, Colborn DK, Bernard BS, Rockette HE, Janosky JE, Pitcairn DL, Sabo DL, Kurs-Lasky M, Smith CG. Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years. N Engl J Med. 2001 Apr 19;344(16):1179–1187.
Coyte PC, Croxford R, McIsaac W, Feldman W, Friedberg J. The role of adjuvant adenoidectomy and tonsillectomy in the outcome of the insertion of tympanostomy tubes. N Engl J Med. 2001 Apr 19;344(16):1188–1195.
Hammaren-Malmi S, Saxen H, Tarkkanen J, Mattila PS. Adenoidectomy does not significantly reduce the incidence of otitis media in conjunction with the insertion of tympanostomy tubes in children who are younger than 4 years: a randomized trial. Pediatrics. 2005 Jul;116(1):185–189.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Humana Press, a part of Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Albert, R.H., Skolnik, N.S. (2008). Treatment and Management of Acute Otitis Media. In: Skolnik, N.S., Albert, R.H. (eds) Essential Infectious Disease Topics for Primary Care. Current Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-034-2_3
Download citation
DOI: https://doi.org/10.1007/978-1-60327-034-2_3
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-58829-520-0
Online ISBN: 978-1-60327-034-2
eBook Packages: MedicineMedicine (R0)