Management of otitis media

Abstract

Although ear care is not as high on the health agenda as asthma or diabetes, ear infections can be just as dangerous. The World Health Organization (WHO) attributes 51 000 deaths each year to otitis media in children under 5 years. In terms of disability-adjusted life years, otitis media compares with meningitis, polio and trachoma (WHO, 1993). Although the aetiology of acute otitis media is similar in both developed and developing countries, the complication rates of chronic serous otitis media and mastoiditis in developing countries are comparable to those in Europe and the USA in the pre-antibiotic 1930s and 1940s (Crosby et al, 2004). Treatment of otitis media can be confusing and it is important to have clear guidelines in order to decide which children should be treated and for which children a watchful waiting approach may be preferred.