Acute otitis media in infants younger than three months not vaccinated against Streptococcus pneumoniae

Sommerfleck, Patricia Alejandra; Macchi, M E González; Pellegrini, S.; Bernáldez, Patricia Cristina; Reijtman, Vanesa; Hernández, C; Lopardo, Horacio

doi:10.1016/j.ijporl.2013.03.024

Cited by 12 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Resistance to fluoroquinolones has also been demonstrated 72,75. Similarly, nontypeable H. influenza e, the main serotype responsible for OM, frequently produces beta-lactamase, and is thus resistant to ampicillin;29,76,77 amoxicillin/clavulanate may be preferred,77 but a study in Spain found that 13% of the nontypeable H. influenza e isolates were even amoxicillin/clavulanate resistant 29…”

Section: Emerging Strategies In Prevention and Treatmentmentioning

confidence: 99%

Update on otitis media – prevention and treatment

Qureishi¹,

Lu²,

Belfield³

et al. 2014

IDR

106

View full text Add to dashboard Cite

Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.

show abstract

Section: Emerging Strategies In Prevention and Treatmentmentioning

confidence: 99%

Update on otitis media – prevention and treatment

Qureishi¹,

Lu²,

Belfield³

et al. 2014

IDR

106

View full text Add to dashboard Cite

show abstract

“…Compared to older children, infants who experience AOM before age 12 months are more likely to experience recurrent AOM, prolonged middle ear effusion, concomitant conductive hearing loss, and a greater likelihood of requiring tympanostomy tube surgery [2,4]. Also, very young infants may be susceptible to pneumococcal AOM because they may not have been fully immunized with pneumococcal vaccine [5]. Worldwide, parents consider the symptoms of AOM to be a burden [6].…”

Section: Introductionmentioning

confidence: 99%

Use of symptoms and risk factors to predict acute otitis media in infants

McCormick

Jennings

Ede

et al. 2016

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

Objectives Infants and children with upper respiratory tract infection (URI) often have concurrent acute otitis media (AOM). Young infants have less specific symptoms than older children. The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants. Methods Healthy infants, age ≤ four weeks, were enrolled and followed prospectively for up to age one year. Infants were scheduled for a research visit when their parents noted the onset of symptoms. At each URI visit, parents first reported the severity of symptoms. An investigator then diagnosed the presence or absence of concurrent AOM. Risk factors and symptom scores for infants with and without AOM were studied. Results Infants (N=193, mean age at first URI 3.9 ± 2.5 months) experienced 360 URI episodes and 63 AOM events. Symptoms consisting of fever, earache, poor feeding, restless sleep, and irritability together (ETG-5) were statistically associated with the prediction of AOM (P=0.006). A multiple variable statistical model (J-Score) that included day care attendance, age, severity of cough and earache best predicted AOM (P < 0.001), with 95% specificity. Both ETG-5 and J-score yielded relatively low sensitivity for AOM prediction. Conclusions : In infants with URI in the first year of life, severity of symptoms was significantly associated with concurrent AOM. Daycare attendance, presence and severity of earache and cough added to better correlation. These observations may have clinical application in identification of infants at risk for AOM.

show abstract

“…In previous studies, researchers have used the examination by otolaryngologists, who often use surgical microscopes and/or tympanocentesis results to support the clinical diagnosis of AOM. 3,4,6,7 However, these methods are not routinely used in current clinical practice. 19 Although examining the ears of young infants is technically challenging, previous researchers have demonstrated successful use of otoscopy to diagnose AOM in infants younger than 8 weeks, with 52% to 85% of middle ear effusion cultures yielding growth of true otopathogens after tympanocentesis.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, researchers have suggested a low prevalence of bacteremia among infants with AOM, but these studies were limited by small sample sizes and included mixed populations of infants with and without fever. [3][4][5][6][7][8] The clinical conundrum of AOM in infants younger than 3 months may be most relevant to those without fever, for whom the appropriate diagnostic evaluation for IBI, if any, is unclear.…”

mentioning

confidence: 99%

Invasive Bacterial Infections in Afebrile Infants Diagnosed With Acute Otitis Media

et al. 2021

View full text Add to dashboard Cite

OBJECTIVES: To determine the prevalence of invasive bacterial infections (IBIs) and adverse events in afebrile infants with acute otitis media (AOM). METHODS: We conducted a 33-site cross-sectional study of afebrile infants ≤90 days of age with AOM seen in emergency departments from 2007 to 2017. Eligible infants were identified using emergency department diagnosis codes and confirmed by chart review. IBIs (bacteremia and meningitis) were determined by the growth of pathogenic bacteria in blood or cerebrospinal fluid (CSF) culture. Adverse events were defined as substantial complications resulting from or potentially associated with AOM. We used generalized linear mixed-effects models to identify factors associated with IBI diagnostic testing, controlling for site-level clustering effect. RESULTS: Of 5270 infants screened, 1637 met study criteria. None of the 278 (0%; 95% confidence interval [CI]: 0%–1.4%) infants with blood cultures had bacteremia; 0 of 102 (0%; 95% CI: 0%–3.6%) with CSF cultures had bacterial meningitis; 2 of 645 (0.3%; 95% CI: 0.1%–1.1%) infants with 30-day follow-up had adverse events, including lymphadenitis (1) and culture-negative sepsis (1). Diagnostic testing for IBI varied across sites and by age; overall, 278 (17.0%) had blood cultures, and 102 (6.2%) had CSF cultures obtained. Compared with infants 0 to 28 days old, older infants were less likely to have blood cultures (P < .001) or CSF cultures (P < .001) obtained. CONCLUSION: Afebrile infants with clinician-diagnosed AOM have a low prevalence of IBIs and adverse events; therefore, outpatient management without diagnostic testing may be reasonable.

show abstract

Acute otitis media in infants younger than three months not vaccinated against Streptococcus pneumoniae

Abstract: S. pneumoniae is the most frequent pathogen to cause AOM in this age group. Empirical treatment with amoxicillin or ceftriaxone should be considered depending on clinical suspicion of severe invasive infection.

Cited by 12 publications

References 15 publications

Update on otitis media – prevention and treatment

Update on otitis media – prevention and treatment

Use of symptoms and risk factors to predict acute otitis media in infants

Invasive Bacterial Infections in Afebrile Infants Diagnosed With Acute Otitis Media

Contact Info

Product

Resources

About

Acute otitis media in infants younger than three months not vaccinated against Streptococcus pneumoniae

Abstract: S. pneumoniae is the most frequent pathogen to cause AOM in this age group. Empirical treatment with amoxicillin or ceftriaxone should be considered depending on clinical suspicion of severe invasive infection.

Cited by 12 publications

References 15 publications

Update on otitis media &ndash; prevention and treatment

Update on otitis media &ndash; prevention and treatment

Use of symptoms and risk factors to predict acute otitis media in infants

Invasive Bacterial Infections in Afebrile Infants Diagnosed With Acute Otitis Media

Contact Info

Product

Resources

About

Update on otitis media – prevention and treatment

Update on otitis media – prevention and treatment