Tuesday, November 23, 2010

Treatment of Otitis Media

A meta-analysis just published here reviews the diagnosis, microbiology and treatment of acute otitis media (AOM) in children. I have always been surprised by the low numbers of kids with AOM I see, compared with the reported prevalence. The results of this paper were quite interesting; the presence of a bulging tympanic membrane and redness of the membrane were associated with a positive diagnosis. nothing surprising there.

Following the introduction of heptavalent pneumococcal conjugate vaccine (PCV7), Streptococcus pneumoniae decreased, while that of Haemophilus influenzae increased.

The authors concluded, "otoscopic findings are critical to accurate AOM diagnosis. AOM microbiology has changed with use of PCV7. Antibiotics are modestly more effective than no treatment butcause adverse effects in 4% to 10% of children. Most antibiotics have comparable clinical success."

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