title: Otitis media.
abstract: Acute otitis media (AOM) is diagnosed based on visualization of a full or bulging tympanic membrane with middle ear effusion. The distribution of bacteria causing AOM in North America under the influence of pneumococcal conjugate vaccination and antibiotic selection pressure has resulted in a predominance of β-lactamase-producing Haemophilus influenzae followed by penicillin-resistant Streptococcus pneumoniae. Although guidelines continue to endorse amoxicillin as the preferred treatment, amoxicillin/clavulanate in high dosage would be the preferred treatment based on the otopathogen mix currently. Antibiotic prophylaxis has fallen into disfavor as a preventative strategy for AOM recurrences.
authors.affiliation: Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester General Hospital, Rochester, NY 14621, USA. Michael.pichichero@rochestergeneral.org
authors.forename: Michael E
authors.initials: ME
authors.lastname: Pichichero
mesh_terms: D000367:Age Factors; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D000077525:Cefdinir; D015296:Ceftizoxime / Q000031:analogs & derivatives / Q000627:therapeutic use; D002444:Cefuroxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000188:drug therapy; D038781:Otoscopy; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013997:Time Factors; D014432:Tympanic Membrane / Q000473:pathology / Q000503:physiopathology; D000097627:Cefpodoxime Proxetil
chemical_list: D000658:Amoxicillin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000900:Anti-Bacterial Agents; D000077525:Cefdinir; D015296:Ceftizoxime; D002444:Cefuroxime; D002511:Cephalosporins; D000097627:Cefpodoxime Proxetil