Acute Otitis Media- An Update

Abstract

Objective: To review the literature about Acute otitis media (AOM).Introduction: AOM is a common condition with an incidence of 10.8/ 100 people per year; it is more common in pediatric age group and tends to occur more in male patients. It is considered the main cause of prescribing antibiotics in pediatrics. Physicians tend to over diagnose this disease leading to an unnecessary antibiotics prescription which exposes the child to an unwanted side effects mainly diarrhea. USA spends $2-3.5 billion per year for the treatment of AOM. Taking these points in our mind, it is important to know how to accurately diagnose this condition and how to treat it and what is the pathophysiology that underlies that disease, all of which are discussed in details in this review article.Methodology: a comprehensive review of the literature about AOM.Results: AOM is a result of different host, environmental, microbiological and genetic factors. It is highly related to upper respiratory infection and the disease is thought to be viral in origin with bacterial superinfection happens later on. Respiratory syncytial virus (RSV) has the best link with AOM. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are still the most important pathogens. It is a symptomatic disease; Ear pain is the most important symptom, and bulging of the tympanic membrane is the most important sign that can lead to diagnosis. The American Academy of Pediatrics has put certain guidelines for the treatment of AOM. Prevetive measures play an important role in decreasing of its incidence. Conclusion:AOM has an impact on the child, family, and the community as a whole, in term of health and costs.

New Paradigms in the Management of Acute Otitis Media

“…Giving decongestants and antihistamines is not advised. 13 When it comes to patients with recurrent otitis media (rOM), the use of prophylactic antibiotics is not recommended due to the lack of substantial evidence supporting their effectiveness. The decision regarding grommet insertion, a surgical procedure involving the placement of ventilation tubes in the eardrums, remains a topic of controversy in the management of rOM.…”

“…Taking a holistic approach that includes optimizing the child's immune system, promoting healthy habits, and considering the broader impact on quality of life can further enhance the management of rOM. Healthcare providers should tailor the management approach to each individual case, considering the specific needs and circumstances of the patient.. 13 Children with AOM should receive pain medication as necessary. For a brief period of time (less than 48 hours), oral ibuprofen or acetaminophen monotherapy relieves ear pain.…”

Acute Otitis Media

“…Paternal smoking and exposure to smoking through other routes are among the major risk factors for AOM; exposure to smoke induces mucosal inflammation, goblet hyperplasia, and increased mucus production, thus impairing the immune response of the respiratory epithelium and increasing pathogen bacterial colonization via increased bacterial binding [27].…”