B3.054 Otitis Media Flashcards
most common condition for which antimicrobial agents are prescribed in the US for children
otitis media
when do children usually get AOM?
coincident with or following a viral upper respiratory tract infection
what happens in 75% of kids with an URI
Eustachian tube dysfunction
discuss the breakdown of viral vs bacterial AOM cases
96% virus and/or bacteria
66% both
27% bacteria alone
4% viruses alone
4 most common bacterial pathogens of URIs
S. pneumoniae
H. influenzae
M. catarrhalis
S. pyogenes
what has caused certain serotypes of S. pneumo to decrease?
conjugate pneumococcal vaccine
pen resistant isolates also decreased
most likely cause of otitis-conjunctivitis
non typeable H. influenzae (NTHi)
best way to confirm AOM
tympanocentesis and bacterial culture of middle ear fluid
what factors increase the risk of AOM
daycare
non-Hispanic white
atopy (allergies, asthma)
siblings/ fam history of recurrent AOM
risk factors for RECURRENT AOM
male sex
day car
fam history
first episode within first 6 mo of life
what qualifies as recurrent AOM
> 3 episodes in 6 months or >4 in 1 year
protective against AOM
breastfeeding in first 6 months
strong recommendation
follow unless a clear and compelling rationale for an alternate approach is present
recommendation
prudent to follow but should remain alert to new info and sensitive to patient preferences
option
consider the option in their decision making and patient preference may have a substantial role
no recommendations
be alert to new published evidence that clarifies balance of benefit vs harm
symptoms of AOM
rapid onset of ear pain
preverbal: tugging/rubbing/holding of the war, crying, fever, changes in sleep/ behavior