[Epidemiology and burden of acute otitis media in Valencia (Spain)].
OBJECTIVE
To assess the burden (incidence, treatment and complications) of acute otitis media (AOM) and otitis media with effusion (OME) in children younger than 5 years of age from Valencia, Spain.


METHODS
We performed a retrospective cohort study of 1,399 children followed-up for the first 5 years of life. Seventeen pediatricians reviewed the medical records of their patients born in 1995 and 1996 and followed-up from birth until the age of 5 years. For each child, the number of otitis episodes, treatment, complications, and surgical interventions was obtained.


RESULTS
There were 2,961 episodes of AOM in the first 5 years of life (2.23 cases/child). Four hundred seventy-six cases (16.1 %) occurred before 1 year of age and 1,346 between the first and second year of life (45.5 %). By the third year of life, 59.8 % had had at least one episode. In most children (80.9 %), diagnosis was made in primary care and required a median of 1.81 visits/episode for follow-up. A total of 94.5 % were treated with antibiotics (amoxicillin-clavulanate 38.8 %, cefuroxime 14.3 %, clarithromycin 8.2 % and amoxicillin 5.9 %) and 8.5 % required a change of antibiotic therapy. Two hundred seventeen children (15.2 %) had at least one episode of OME. Twenty-six patients (1.8 %, 95 % CI: 1.2-2.7 %) required insertion of ventilation tubes. Twenty-four patients (1.7 %) had secondary hypoacusis. There was one case of meningitis and two cases of chronic otorrhea. No cases of mastoiditis were recorded.


CONCLUSIONS
The incidence of AOM in Valencia is 40,014 episodes/100,000 children younger than 5 years/year (95 % CI: 39,700-40,300). It represents a significant burden due to the large number of visits, antibiotic use, associated surgical procedures and need for auditory rehabilitation.
Garcés-Sánchez
M
M
Pediatra de Atención Primaria, Instituto de Vacunas de Valencia (VIVA), Spain. maria_garces@terra.es
Díez-Domingo
J
J
Alvarez de Labiada
T
T
Planelles
V
V
Graullera
M
M
Baldo
J Ma
JM
García Llop
L A
LA
García López
M
M
Peris Vidal
A
A
Gallego García
Ma D
MD
Ballester Sanz
A
A
Peidro
C
C
Villarroya
J
J
Jubert
A
A
Colomer Revuelta
J
J
Casani
C
C
D000208:Acute Disease; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology