Acute otitis media: From diagnosis to prevention. Summary of the Italian guideline

Marchisio, Paola; Bellussi, Luisa; Mauro, Giuseppe Di; Doria, Mattia; Felisati, Giovanni; Longhi, Riccardo; Novelli, Andréa; Speciale, A; Mansi, Nicola; Principi, Nicola

doi:10.1016/j.ijporl.2010.08.016

Cited by 80 publications

(88 citation statements)

References 38 publications

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“…Bilateral AOM is nowadays considered more severe than unilateral AOM, and more active antimicrobial treatment and/or follow-up of bilateral AOM is recommended by the guidelines of, for example, the Netherlands, England, Italy, and Sweden, [2][3][4][5] which are largely based on the meta-analysis of Rovers et al 6 According to their results, young children with bilateral AOM benefit more from antimicrobial treatment than those with unilateral AOM. Nevertheless, the symptoms and signs of bilateral and unilateral AOM at the time of diagnosis have previously been compared by only 2 study groups.…”

Section: Discussionmentioning

confidence: 99%

“…Third, we asked parents to assess their child' s overall condition (range, 0-7) at its worst within the preceding 24 hours and at study clinic, by the AOM-faces scale, which was developed by Friedman et al 13 Fourth, we used the modified AOM total severity index (AOM-Si) as suggested by McCormick et al 14 to determine the severity of AOM. We calculated the AOM-Si score (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14] by summing up the highest OS-8 score and the highest AOM-faces scale at its worst within 24 hours. Fifth, based on our symptom questionnaire, we calculated the AOM severity of symptom scale (AOM-SOS; version 3.0), which Shaikh et al 15 created.…”

Section: Methodsmentioning

confidence: 99%

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Symptoms and Otoscopic Signs in Bilateral and Unilateral Acute Otitis Media

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active management of bilateral AOM. However, severity of symptoms and otoscopic signs of bilateral and unilateral AOM have previously not been comprehensively studied.WHAT THIS STUDY ADDS: Bilateral AOM seems to be clinically only a slightly more severe illness than unilateral AOM. When assessing AOM severity, bilaterality should not be used as a determining criterion; instead, the child' s symptoms together with otoscopic signs should also be acknowledged. abstract OBJECTIVE: Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active treatment and/or follow-up of bilateral AOM. We studied whether bilateral AOM is a clinically more severe illness than unilateral AOM by comparing symptoms and otoscopic signs between bilateral and unilateral AOM. METHODS:Two hundred thirty-two children aged 6 to 35 months diagnosed with AOM were eligible. We surveyed the symptoms with a structured questionnaire and recorded the otoscopic signs systematically.RESULTS: Ninety-eight children had bilateral and 134 children unilateral AOM. Children with bilateral AOM were more often ,24 months than children with unilateral AOM (87% vs 75%; P = .032). Fever ($38°C) occurred in 54% and 36% (P = .006) and severe conjunctivitis in 16% and 44% (P = .047) of children with bilateral and unilateral AOM, respectively. In 15 other symptoms, we found no overall differences even when adjusted with age. We observed the following severe otoscopic signs in the bilateral and unilateral AOM group, respectively: moderate/marked bulging of tympanic membrane (63% and 40%; P = .001), purulent effusion (89% and 71%; P = .001), bulla formation (11% and 10%; P = .707), and hemorrhagic redness of tympanic membrane (7% and 10%; P = .386). CONCLUSIONS:Bilateral AOM seems to be a clinically only slightly more severe illness than unilateral AOM. Therefore, when assessing AOM severity, bilaterality should not be used as a determining criterion; instead, the child' s symptomatic condition together with otoscopic signs should also be taken into consideration.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Symptoms and Otoscopic Signs in Bilateral and Unilateral Acute Otitis Media

et al. 2013

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“…In order to avoid unnecessary and unjustified treatments it is therefore imperative to differentiate carefully subjects with AOM from those with OME or other forms (16,17).…”

Section: First Messagementioning

confidence: 99%

What not to do in acute otitis media: the top five recommendations proposed by the Italian Society of Preventive and Social Pediatrics

Chiappini

Bortone

Doria³

et al. 2017

Expert Review of Anti-infective Therapy

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“… Children presenting with severe AOM (fever > 39 °C or acute pain), otorrhea or bilateral AOM 41 . It has been confirmed that these children benefit more from immediate antibiotic treatment (IA) 37 .…”

Section: Groups At Risk For a Poor Outcome: Immediate Antibiotic Treamentioning

confidence: 99%

“… If the presentation is severe or there are risk factors, the treatment will consist of amoxicillin at 80-90 mg/kg per day, divided in two or three doses, for 7-10 (IA) 41 .…”

Section: Children Older Than Two Years Of Agementioning

confidence: 99%