[Acute mastoiditis: increase of incidence and controversies in antibiotic treatment].
An important complication of acute otitis media is acute mastoiditis which responds to antibiotic therapy and myringotomy. Patients with acute mastoiditis were reviewed during 1996-2005 in the tertiary University Children's Hospital in Madrid. The number of patients with acute mastoiditis increased by about 2-fold during this period. Of 205 children with mastoiditis, ranging from 0.6-17 years of age, surgical treatment was needed in about 4.3% in 1996 and in 70% in 2005. In spite of 80% of the children having received antibiotics at the pediatric visit, the number of complications increased (periostitis, subperiosteal abscess), and the number of surgical interventions increased by 8-fold. Etiological agents were Streptococcus pneumoniae (28.5%) and Staphylococcus aureus (16.3%). Negative cultures were obtained in 53.6% of cases. Lack of response to conventional therapy may require more tympanocentesis procedures for a middle ear culture, and surgical therapy may be necessary more often, as is the tendency in our hospital.
Bartolomé Benito
M
M
Department of Otorrinolaringology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain.
Pérez Gorricho
B
B
D000038:Abscess / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D000075202:Contraindications; D004351:Drug Resistance; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D008590:Meningoencephalitis / Q000209:etiology / Q000517:prevention & control; D010033:Otitis Media / Q000150:complications; D010522:Periostitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D012189:Retrospective Studies; D012306:Risk; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents