How to Cite
1.
Quesada Solano S, Mackenzie Visbal F, Cortes Mejia M. Acute otitis media: generalities and antibiotic resistance. Rev.méd.sinerg. [Internet]. 2019May1 [cited 2024Jul.22];4(5):130 - 138. Available from: https://revistamedicasinergia.com/index.php/rms/article/view/207
Abstract
Otitis media (OM) is one of the most common diagnoses in pediatric population and the most frequent indication for the prescription of antibiotics in childhood. The diagnosis of acute otitis media (AOM) is based on the findings of the otoscopy, various clinical signs and the time of evolution of the main symptoms. The decision to initiate antibiotic therapy should be based on the risk stratification of the patient. An alternative observation and close follow-up strategy in selected cases help to reduce the antibiotic exposure, and has also proven to be a cost-effective measure. The drug of choice for the empirical treatment of AOM is amoxicillin. Other treatment options are cephalosporins, macrolides or combinations with β-lactamase inhibitors. Streptococcus pneumoniae resistant to penicillin is the main cause of the therapeutic failure of antibiotics in AOM. The introduction of the pneumococcal conjugate vaccine has changed the frequency of the serotypes of Streptococcus pneumoniae, and has increased the isolation of Haemophilus influenzae in the fluid samples of the middle ear of the patients with AOM. Recent studies have shown an increase in the prevalence of β-lactamase producer agents in patients with AOM.
Keywords
otitis media. watchful waiting. Streptococcus pneumoniae. amoxicillin. drug resistance. microbial.
References
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17.Brinker Jr DL, MacGeorge EL, Hackman N. Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media. Clinical pediatrics. 2019 Jan; 58(1): 60-65.https://doi.org/10.1177/0009922818806312
18.Harrison CJ. Amoxicillin is the most cost-effective therapy for acute otitis media: the culmination of 40 years of research. The Journal of pediatrics. 2017 Oct 1; 189: 5-8.https://doi.org/10.1016/j.jpeds.2017.06.070
19.Ngo CC, Massa HM, Thornton RB, Cripps AW. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review. PLoS One. 2016; 11(3): e0150949.https://doi.org/10.1371/journal.pone.0150949
2. Aguilar-Morales L, Soley-Gutiérrez C, Arguedas-Mohs A. Principios farmacocinéticos y farmacodinámicos en el tratamiento de niños con otitis media. Acta Médica Costarricense. 2006; 48(3): 113-118. Disponible en: http://actamedica.medicos.cr/index.php/Acta_Medica/article/view/460/432
3. Park MK, Nam DW, Byun JY, Hong SM, Bae CH, Lee HY, Jeon EJ, Kim MG, Kim SH, Yeo SG. Differences in Antibiotic Resistance of MRSA Infections in Patients with Various Types of Otitis Media. J Int Adv Otol. 2018 Dec 1; 14(3): 459-63. https://doi.org/10.5152/iao.2018.5374
4. Palma S, Rosafio C, Del Giovane C, Patianna VD, Lucaccioni L, Genovese E, Bertolani P, Iughetti L. The impact of the Italian guidelines on antibiotic prescription practices for acute otitis media in a paediatric emergency setting. Italian journal of pediatrics. 2015 Dec; 41(1): 37. https://doi.org/10.1186/s13052-015-0144-4
5. Korona-Glowniak I, Zychowski P, Siwiec R, Mazur E, Niedzielska G, Malm A. Resistant Streptococcus pneumoniae strains in children with acute otitis media-high risk of persistent colonization after treatment. BMC infectious diseases. 2018 Dec; 18(1): 478. https://doi.org/10.1186/s12879-018-3398-9
6. Gerber JS, Ross RK, Bryan M, Localio AR, Szymczak JE, Wasserman R, Barkman D, Odeniyi F, Conaboy K, Bell L, Zaoutis TE. Association of broad-vs narrow-spectrum antibiotics with treatment failure, adverse events, and quality of life in children with acute respiratory tract infections. Jama. 2017 Dec 19; 318(23): 2325-2336. https://doi.org/10.1001/jama.2017.18715
7. Abdelnour A, Soley C, Guevara S, Porat N, Dagan R, Arguedas A. Streptococcus pneumoniae serotype 3 among Costa Rican children with otitis media: clinical, epidemiological characteristics and antimicrobial resistance patterns. BMC pediatrics. 2009 Dec; 9(1): 52. https://doi.org/10.1186/1471-2431-9-52
8. Krause FJ. Otitis media aguda. Diagnóstico y manejo práctico. Revista Médica Clínica Las Condes. 2016 Nov 1; 27(6): 915-923. https://doi.org/10.1016/j.rmclc.2016.10.004
9. Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, Joffe MD, Miller DT, Rosenfeld RM, Sevilla XD, Schwartz RH. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar 1; 131(3): e964-e999. https://doi.org/10.1542/peds.2012-3488
10. Rosa-Olivares J, Porro A, Rodriguez-Varela M, Riefkohl G, Niroomand-Rad I. Otitis Media: To Treat, To Refer, To Do Nothing: A Review for the Practitioner. Pediatrics in review. 2015 Nov; 36(11): 480-486. https://doi.org/10.1542/pir.36-11-480
11. .Le Saux N, Robinson JL, Canadian Paediatric Society, Infectious Diseases and Immunization Committee. Management of acute otitis media in children six months of age and older. Paediatrics & child health. 2016 Feb 5; 21(1): 39-44. https://doi.org/10.1093/pch/21.1.39
12. Kirk LA. Pediatric Otitis Media: An Update. Physician Assistant Clinics. 2018 Apr 1; 3(2):207-222. https://doi.org/10.1016/j.cpha.2017.11.004
13. Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane Database of Systematic Reviews. 2015; (6): CD000219. https://doi.org/10.1002/14651858.CD000219.pub4
14. Venekamp RP, Damoiseaux RA, Schilder AG. Acute otitis media in children. BMJ clinical evidence. 2014 Sep; 2014: pii 0301.
15. Schilder AG, Marom T, Bhutta MF, Casselbrant ML, Coates H, Gisselsson-Solén M, Hall AJ, Marchisio P, Ruohola A, Venekamp RP, Mandel EM. Panel 7: otitis media: treatment and complications. Otolaryngology-Head and Neck Surgery. 2017 Apr; 156(4_suppl): S88-S105. https://doi.org/10.1177/0194599816633697
16.Sun D, McCarthy TJ, Liberman DB. Cost-effectiveness of watchful waiting in acute otitis media. Pediatrics. 2017 Apr 1; 139(4): e20163086.https://doi.org/10.1542/peds.2016-3086
17.Brinker Jr DL, MacGeorge EL, Hackman N. Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media. Clinical pediatrics. 2019 Jan; 58(1): 60-65.https://doi.org/10.1177/0009922818806312
18.Harrison CJ. Amoxicillin is the most cost-effective therapy for acute otitis media: the culmination of 40 years of research. The Journal of pediatrics. 2017 Oct 1; 189: 5-8.https://doi.org/10.1016/j.jpeds.2017.06.070
19.Ngo CC, Massa HM, Thornton RB, Cripps AW. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review. PLoS One. 2016; 11(3): e0150949.https://doi.org/10.1371/journal.pone.0150949
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