title: Clinical/otologic score before and during treatment of acute otitis media.
abstract: OBJECTIVE
  To determine clinical characteristics of AOM at presentation and during therapy according to specific etiologies.
  
  
  METHODS
  1003 patients studied during 1996-2001 in antibiotic efficacy studies underwent tympanocentesis and middle ear fluid culture at enrollment and on Day 4-6 (in initially culture-positive patients only). We used a clinical/otologic (CO) score for evaluating severity of fever, irritability and tympanic membrane redness and bulging (0-3 each parameter, maximal score=12).
  
  
  RESULTS
  Seven hundred sixty-three patients had positive cultures with 392 (39%) Haemophilus influenzae, 198 (20%) Streptococcus pneumoniae and 173 (17%) mixed H. influenzae and S. pneumoniae infection. Mean CO score was higher in culture-positive versus culture-negative patients (8.21+/-2.17 vs. 7.73+/-2.32, p=0.003) regardless of isolated organism. A marked improvement in CO score was observed on Day 4-6 in all patients: 1.83+/-2.18 in children initially culture-positive and 0.9+/-1.67 in those initially culture-negative (p<0.001). The improvement was greater in patients with eradication versus those with bacteriological failure (CO score 1.52+/-1.82 vs. 2.77+/-2.85, p<0.001).
  
  
  CONCLUSIONS
  CO score before treatment, after bacterial eradication or in bacteriologic failures are similar in bacterial AOM and are not predictive of the etiology of the disease.
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Satran
authors.forename: E
authors.initials: E
authors.lastname: Leibovitz
authors.forename: S
authors.initials: S
authors.lastname: Raiz
authors.forename: L
authors.initials: L
authors.lastname: Piglansky
authors.forename: J
authors.initials: J
authors.lastname: Press
authors.forename: A
authors.initials: A
authors.lastname: Leiberman
authors.forename: R
authors.initials: R
authors.lastname: Dagan
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D006192:Haemophilus Infections / Q000175:diagnosis* / Q000188:drug therapy; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D010033:Otitis Media / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents