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      OTITIS MEDIA AGUDA. DIAGNÓSTICO Y MANEJO PRÁCTICO Translated title: DIAGNOSIS AND MANAGEMENT OF ACUTE OTITIS MEDIA

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          RESUMEN

          La otitis media aguda es una patología infecciosa del oído medio muy frecuente. El diagnóstico es clínico, por lo que es fundamental un acucioso examen físico y una neumootoscopía para evaluar la movilidad timpánica. Hay dos tendencias respecto al manejo, tratamiento antibiótico inmediato u observación estricta (dependiendo de las características del paciente y del cuadro clínico). Los gérmenes más frecuentes son los virus, Neumococo, Haemophilus influenza y Moraxella catarrhalis. La prevalencia de cada uno de ellos varía según región geográfica y según la presencia de vacunación. La resistencia a antibióticos ha ido en aumento en estos años, pero aún puede considerarse sensible a amoxicilina por lo que se recomienda su uso como primera línea. En el caso de fracaso a tratamiento pueden utilizarse asociaciones con B-lactámicos y/o cefalosporinas, dejando en forma excepcional clindamicina o quinolonas. Aquellos niños con OMA recurrente requerirán evaluación por especialidad para mayor estudio y tratamiento.

          SUMMARY

          Acute otitis media is a very frequent cause of medical visit and antimicrobial use in children. Clinical diagnosis should be performed with pneumatic otoscopy. Management of AOM requires a thorough clinical exam and updated knowledge of local patterns of microorganisms involved and antimicrobial susceptibility profiles, knowing that the presence of these microorganisms in AOM transtimpanic exudate cultures may vary depending on geographical areas and vaccination. AOM can be treated either with inmediate antibiotic or with observation depending on patients and clinical characteristics. The most common microorganism causing AOM are Pneumococcus, Haemophilus Influenzae, and Moraxella catarrhalis. S. pneumoniae has acquired resistance to penicillin in the last decade that cannot be extrapolated to Amoxicillin. Based on this data Amoxicillin is recommended as the first choice. For amoxicillin failure, cefalosporins or B lactamase can be prescribed. Patients that presents with recurrent AOM should be refered to otolaryngologist for further evaluation and treatment.

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          Drug allergy: an updated practice parameter.

          , , … (2010)
          Adverse drug reactions (ADRs) result in major health problems in the United States in both the inpatient and outpatient setting. ADRs are broadly categorized into predictable (type A and unpredictable (type B) reactions. Predictable reactions are usually dose dependent, are related to the known pharmacologic actions of the drug, and occur in otherwise healthy individuals, They are estimated to comprise approximately 80% of all ADRs. Unpredictable are generally dose independent, are unrelated to the pharmacologic actions of the drug, and occur only in susceptible individuals. Unpredictable reactions are subdivided into drug intolerance, drug idiosyncrasy, drug allergy, and pseudoallergic reactions. Both type A and B reactions may be influenced by genetic predisposition of the patient
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            Diagnosis and management of acute otitis media.

            (2004)
            This evidence-based clinical practice guideline provides recommendations to primary care clinicians for the management of children from 2 months through 12 years of age with uncomplicated acute otitis media (AOM). The American Academy of Pediatrics and American Academy of Family Physicians convened a committee composed of primary care physicians and experts in the fields of otolaryngology, epidemiology, and infectious disease. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to AOM. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific definition of AOM. It addresses pain management, initial observation versus antibacterial treatment, appropriate choices of antibacterials, and preventive measures. Decisions were made based on a systematic grading of the quality of evidence and strength of recommendations, as well as expert consensus when definitive data were not available. The practice guideline underwent comprehensive peer review before formal approval by the partnering organizations. This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem.
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              Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study.

              J. Klein, B Rosner, D W Teele (1989)
              To determine the epidemiology of acute otitis media (AOM) and duration of middle ear effusion (MEE), we followed consecutively enrolled children from shortly after birth until 7 y of age. Because some children dropped out of the study, data were analyzed for 877 children observed for at least 1 y; 698 were observed for at least 3 y, and 498 were observed until 7 y of age. By 1 y of age, 62% of the children had greater than or equal to 1 episode of AOM and 17% had greater than or equal to 3 episodes; by 3 y of age, 83% had greater than or equal to 1 episode of AOM and 46% had greater than or equal to 3 episodes. The peak incidence occurred during the second 6-mo period of life. Significantly increased risk (by multivariate analysis) for AOM was associated with male gender, sibling history of recurrent AOM, early occurrence of AOM, and not being breast fed. MEE persisted after onset of AOM for weeks to months; prolonged duration of MEE was associated with male gender, sibling history of ear infection, and not being breast fed.
              Article 0 comments Cited 101 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Francisco J. Krause
                Journal
                Title: Revista Médica Clínica Las Condes
                Publisher: Published by Elsevier España, S.L.U. on behalf of Clínica Las Condes.
                ISSN (Print): 0716-8640
                ISSN (Electronic): 0716-8640
                Publication date PMC-release: 14 December 2016
                Publication date (Print): November 2016
                Publication date (Electronic): 14 December 2016
                Volume: 27
                Issue: 6
                Pages: 915-923
                Affiliations
                [0005]Departamento de Otorrinolaringología, Clínica Las Condes. Santiago, Chile
                Article
                Publisher ID: S0716-8640(16)30127-4
                DOI: 10.1016/j.rmclc.2016.10.004
                PMC ID: 7148879
                SO-VID: e734595f-a038-4fd5-97e2-0842a18e691f
                Copyright © © 2016 Published by Elsevier España, S.L.U. on behalf of Clínica Las Condes.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 6 June 2016
                Date accepted : 11 October 2016
                Categories
                Subject: Article

                Keywords: otitis media aguda,tratamiento,antibióticos,epidemiología,diagnóstico,guía de manejo,microbiología,vacunas,acute otitis media,treatment,antibiotics,epidemiology,diagnose,microbiology,vaccines
                Data availability:
                Keywords: otitis media aguda, tratamiento, antibióticos, epidemiología, diagnóstico, guía de manejo, microbiología, vacunas, acute otitis media, treatment, antibiotics, epidemiology, diagnose, microbiology, vaccines

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