Documento de consenso sobre etiología, diagnóstico y tratamiento de la otitis media aguda

Martín, F. del Castillo; Baquero-Artigao, Fernando; Cabrera, T. de la Calle; Robles, Mirna Vázquez; Canela, Jaume; Miguélez, S. Alfayate; Llop, F.A. Moraga; Ortega, María José Cilleruelo; Calvo, Cristina

doi:10.1016/j.anpedi.2012.05.026

Cited by 26 publications

(8 citation statements)

References 47 publications

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“…It is important that we not only know how attending childcare influences contracting the pathologies under study, but also how it influences the number of episodes suffered, so we calculated the difference between the cohort means, and found significant differences for several of these pathologies: bronchiolitis, bronchitis, conjunctivitis, gastroenteritis, acute otitis media, common cold, and wheezing. Still, the study of recurrent otitis in particular did not contribute definitive data; in accordance with the definition included in the consensus document on otitis media 11 , the presence of at least three episodes of otitis within six months was considered recurrent otitis. In the age range under study (6 to 12 months), only four children who did not attend childcare met these criteria (0.4%) presenting a maximum of four episodes, and among those who did attend childcare, another four met the criteria (3.4%), although they suffered a higher number of episodes, up to a total of eight in this span of time.…”

Section: Discussionmentioning

confidence: 99%

Influencia de la asistencia a guarderías sobre la morbilidad en niños menores de 12 meses de edad

Aurrecoechea¹,

Francés²,

Alonso³

et al. 2012

Rev Pediatr Aten Primaria

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Influencia de la asistencia a guarderías sobre la morbilidad en niños menores de 12 meses de edad Introduction: the current structure of Spanish society favors the attendance of children at day care to increasingly early ages. This is a risk factor in itself to the condition of infection of the upper and lower respiratory tract, as well as acute otitis media, gastrointestinal infections and other infections. Objective: to evaluate the influence of day care attendance on the risk of infections in children under 12 months of age. Population and methods: prospective longitudinal study. Children born between 1 January and 30 September 2010, attending primary care pediatrics' offices, were included. We excluded children who had severe respiratory or cardiac disease or severe immune deficiency. The data were obtained from computerized medical records and interviews with parents in scheduled visits at 6 and 12 months. In the statistical analysis of the data the statistical software R © (R Development Core Team, 2011) was used. Results: children who attend day care have one or more infectious episodes in higher percentages with statistically significant (p-value <0.05) differences for bronchiolitis, bronchitis, conjunctivitis, tonsillopharyngitis, acute gastroenteritis, laryngitis, pneumonia, acute otitis media, common cold, wheezing, sinusitis and for total pathologies. Attendance at nursery could be responsible for between 35% and 50% of the acute otitis, gastroenteritis, bronchiolitis and bronchitis. Conclusion: taking into account these results, it seems advisable to try other different ways for the care of children in early ages. Introducción: la estructura actual de la sociedad española favorece la asistencia de los niños a guarderías infantiles a edades cada vez más tempranas. Esto es un factor de riesgo por sí solo para el padecimiento de infecciones del tracto respiratorio superior e inferior, otitis media aguda, infecciones gastrointestinales y otras infecciones. Objetivo: evaluar la influencia de la asistencia a la guardería sobre el riesgo de padecer infecciones en los niños menores de 12 meses de edad. Población y métodos: estudio longitudinal prospectivo. Se incluyeron en el estudio los niños nacidos entre el 1 de enero y el 30 de septiembre de 2010 que acuden a consulta de Pediatría de Atención Primaria. Se excluyeron los niños que presentaban patología respiratoria o cardiaca grave o inmunodeficiencias graves. Los datos se obtuvieron de la historia clínica informatizada y de las entrevistas en visitas programadas a los padres a los 6 y a los 12 meses. Para el análisis estadístico de los datos se utilizó el programa estadístico R® (R Development Core Team, 2011).

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Section: Discussionmentioning

confidence: 99%

Influencia de la asistencia a guarderías sobre la morbilidad en niños menores de 12 meses de edad

Aurrecoechea¹,

Francés²,

Alonso³

et al. 2012

Rev Pediatr Aten Primaria

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“…The secondary end point was the frequency of an otitis-related pathogen carriage in the external auditory canal. The inclusion criteria were at least four episodes of AOM during the preceding 12 months or at least three episodes during the preceding 6 months [ 52 ]. The exclusion criteria included chronic medication, chronic illnesses, lip or palatal cleft, programmed tympanostomy or adenoidectomy during the study, and lactose intolerance or cow’s milk protein allergy (because of the excipient used to administer the strain).…”

Section: Methodsmentioning

confidence: 99%

“…A physical examination was performed by a pediatrician for each suspected AOM episode. AOM was diagnosed according to defined clinical criteria [ 52 , 53 ], including evidence of middle ear effusion, inflammation of the tympanic membrane and any other sign of an acute infection (fever, ear ache, otorrhoea, etc.). The number of AOM episodes and the duration of each episode were also recorded and compared to the same data obtained in the 6 months preceding the probiotic treatment.…”

Section: Methodsmentioning

confidence: 99%

Prevention of Recurrent Acute Otitis Media in Children Through the Use of Lactobacillus salivarius PS7, a Target-Specific Probiotic Strain

et al. 2019

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Acute otitis media (AOM) is one of the most common bacterial infections in children. Empiric antibiotherapy leads to increasing antimicrobial resistance rates among otopathogens and may impair the correct development of the microbiota in early life. In this context, probiotics seem to be an attractive approach for preventing recurrent AOM (rAOM) through the restoration of the middle ear and nasopharyngeal microbiota. The aim of this study was the selection of a probiotic strain (Lactobacillus salivarius PS7), specifically tailored for its antagonism against otopathogens. Since L. salivarius PS7 was safe and displayed a strong antimicrobial activity against otopathogens, its efficacy in preventing rAOM was assessed in a trial involving 61 children suffering from rAOM. Children consumed daily ~1 × 109 CFU of L. salivarius PS7, and the number of AOM episodes were registered and compared with that observed in the previous 6 and 12 months. The microbiota of samples collected from the external auditory canal samples was quantitatively and qualitatively assessed. The number of AOM episodes during the intervention period decreased significantly (84%) when compared to that reported during the 6 months period before the probiotic intervention. In conclusion, L. salivarius PS7 is a promising strain for the prevention of rAOM in infants and children.

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“…Justificación: la OMA en la infancia es una de las enfermedades más frecuentes y la principal causa de prescripción de antibióticos en los países desarrollados. En varias Guías y Consensos se está generalizando la recomendación de retrasar el tratamiento con antibióticos de 48 a 72 horas en niños mayores de tres años, si el cuadro clínico no es grave [2][3][4][5] . En el grupo de menores de tres años hay diferencias sobre la decisión de iniciar el tratamiento.…”

Section: Comentario Críticounclassified

“…La Guía NICE, la Revisión Cochrane y la nueva guía de la Academia Americana de Pediatría 3,5,6 recomiendan una conducta de tratamiento diferido en niños en los que se pueda asegurar el seguimiento y no tengan clínica grave, otitis bilateral y otorrea. Otro grupo de guías, como en España el reciente consenso de la OMA 4 , recomiendan el antibiótico desde el inicio. Son necesarios más estudios para establecer cuáles de estos pacientes pueden beneficiarse de un tratamiento diferido.…”

Section: Comentario Críticounclassified

¿Debemos tratar con antibióticos de forma diferida las otitis de los lactantes?

Cruz

Cáceres

2013

Rev Pediatr Aten Primaria

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Should we treat otitis with delayed antibiotics in infants? Conclusiones de los autores del estudio: el inicio tardío de antibioticoterapia no empeora la recuperación de una otitis media aguda (OMA), valorada por una mejoría en los signos y síntomas de esta entidad. Sin embargo, la demora hasta el inicio de los antibióticos puede asociarse a un empeoramiento clínico transitorio con prolongación de los síntomas y pérdidas económicas. Comentario de los revisores: este estudio no ofrece información válida en la que sustentar un cambio de nuestra práctica clínica en cuanto a la decisión de tratar precozmente o no las otitis en los niños entre seis meses y tres años de edad. Son necesarios más estudios para establecer cuáles de estos pacientes pueden beneficiarse de un tratamiento diferido. Authors' conclusions: the delayed antibiotic treatment doesn't make worse the recovery from acute otitis media, assessed through improvement in signs and symptoms. Nevertheless the delay until the starting of antibiotics can be associated to a transient clinical deterioration with a longer period of symptoms and economic losses. Reviewers' commentary: this study doesn't provide valuable information to base a change in our clinical practice regarding the decision to treat early or not the otitis in children between 6 months and 3 years old. Further studies are needed to establish which of these patients may benefit from delayed treatment.

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Documento de consenso sobre etiología, diagnóstico y tratamiento de la otitis media aguda

Cited by 26 publications

References 47 publications

Influencia de la asistencia a guarderías sobre la morbilidad en niños menores de 12 meses de edad

Influencia de la asistencia a guarderías sobre la morbilidad en niños menores de 12 meses de edad

Prevention of Recurrent Acute Otitis Media in Children Through the Use of Lactobacillus salivarius PS7, a Target-Specific Probiotic Strain

¿Debemos tratar con antibióticos de forma diferida las otitis de los lactantes?

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