Acute otitis media-diagnosis and treatment in the era of antibiotic resistant organisms: updated clinical practice guidelines.
The treatment of children with AOM has to rely on an accurate diagnosis and a clear discrimination between AOM and serous otitis media. The last decade has seen major changes in the epidemiology of AOM with an earlier onset of disease and a greater proportion of children with recurrent/complicated AOM. The processes of changing susceptibility of bacterial pathogens added a major problem in treatment selection. Tastier, more efficient, safe and conveniently-dosing as well as cost effective drugs are required to achieve adherence to therapy. The recent published guidelines for the treatment of AOM in the present era of pneumoccocal resistance represent a major step forward in the approach to the management of this disease by establishing a clear hierarchy among the various therapeutic agents. A 48-72 h observation option without use of antibacterial therapy in selected children with uncomplicated AOM should be promoted. Immunization against S. pneumoniae with the heptavalent pneumococcal conjugated vaccines was showed to result in a decrease in the frequency of AOM caused by this pathogen, including AOM caused by antibiotic-resistant S. pneumoniae.
Segal
Nili
N
Department of Otolaryngology - Head & Neck Surgery, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva 84101, Israel.
Leibovitz
Eugene
E
Dagan
Ron
R
Leiberman
Alberto
A
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010033:Otitis Media / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents