title: Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan - 2013 update.
abstract: OBJECTIVE
  To (1) indicate methods of diagnosis and testing for childhood (<15 years) acute otitis media (AOM) and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of AOM in Children (Subcommittee of Clinical Practice Guideline), in light of the causative bacteria and their drug sensitivity of AOM in Japan.
  
  
  METHODS
  We investigated the most recently detected bacteria causing childhood AOM in Japan as well as antibacterial sensitivity and the worldwide distinct progress of vaccination, produced Clinical Questions concerning the diagnosis, testing methods, and treatment of AOM, searched literature published during 2000-2004, and issued the 2006 Guidelines. In the 2009 and 2013 Guidelines, we performed the same investigation with the addition of literature, which were not included in the 2006 Guidelines and published during 2005-2008 and during 2009-2012, respectively.
  
  
  RESULTS
  We categorized AOM as mild, moderate, or severe on the basis of tympanic membrane findings and clinical symptoms, and presented recommended treatment for each degree of severity.
  
  
  CONCLUSIONS
  Accurate assessment of tympanic membrane findings is important for judging the degree of severity and selecting a method of treatment. Some of new antimicrobial agents and pneumococcal vaccination are recommended as new treatment options.
authors.affiliation: Department of Otolaryngology, Chigasaki Central Hospital, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
authors.affiliation: Kamide ENT Clinic, Shizuoka, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kamide
authors.affiliation: Department of Nutrition, Faculty of Health Care Science, Chiba Prefectural University of Health Sciences, Japan.
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Kudo
authors.affiliation: Department of Health Informatics, Kyoto University Graduate School of Medicine, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Otolaryngology, Banbuntane Houtokukai Hospital, Fujita Health University School of Medicine, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Otorhinolaryngology, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Taiji
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan. Electronic address: htak0831@nagasaki-u.ac.jp.
authors.forename: Haruo
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Otolaryngology - Head & Neck Surgery, Wakayama Medical University, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamanaka
authors.affiliation: UNO ENT Clinic, Okayama, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Uno
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003939:Diagnostic Techniques, Otological; D006192:Haemophilus Infections / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007564:Japan; D010033:Otitis Media / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D038781:Otoscopy; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D014432:Tympanic Membrane / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines
keywords: Acute otitis media (AOM); Antimicrobial agent; Multidrug-resistant bacteria; Recurrent otitis media (ROM); Treatment algorithm; Vaccination