Medicus, Vol. 14 No. 1_ARI, 2005.
Review article
Acute Otitis Media
Srećko Branica
Abstract
Otitis media is the most common childhood
infection for which antibiotics are prescribed. Acute
otitis media (AOM) is usually a short-term infl ammation of
the middle ear, and is principally characterized by earache
that may be severe. It is often preceded by upper respiratory
symptoms, including a cough and rhinorrhoea. AOM is
usually considered a simple bacterial infection, but viruses
are also playing the important role in the etiology and pathogenesis.
The most common bacterial causes are Streptococcus
pneumoniae, Haemophilus infl uenzae, and Moraxella
catarrhalis. Despite a large number of published studies
and clinical trials, there is still no national or international
consensus on the best treatment of AOM. Amoxicillin is the
recommended fi rst-line antibiotic for uncomplicated AOM
in many countries. Among the more active agents against
these three bacteria are amoxicillin-clavulanate, cefuroxime
axetil and the injectable drug ceftriaxone. The macrolide
antibiotics are recommended if amoxicillin is contraindicated
because of a true history of allergy to penicillin. Antibiotics
reduce the proportion of children still in pain at 2-7
days and reduce the risk of developing contralateral AOM.
Selective use of tympanocentesis if the patient does not
respond to antibiotic therapy can help confi rm the diagnosis
and guide effective therapy. Severe progressive complications
of AOM, such as mastoiditis, labyrinthitis, meningitis,
intracranial sepsis, or facial nerve palsy are rare.
Keywords
acute otitis media; children; treatment
Hrčak ID:
18539
URI
Publication date:
26.1.2005.
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