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Diagnosis and treatment of otitis media.
Am Fam Physician. 2007 Dec 01; 76(11):1650-8.AF

Abstract

Diagnostic criteria for acute otitis media include rapid onset of symptoms, middle ear effusion, and signs and symptoms of middle ear inflammation. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common bacterial isolates from the middle ear fluid of children with acute otitis media. Fever, otalgia, headache, irritability, cough, rhinitis, listlessness, anorexia, vomiting, diarrhea, and pulling at the ears are common, but nonspecific symptoms. Detection of middle ear effusion by pneumatic otoscopy is key in establishing the diagnosis. Observation is an acceptable option in healthy children with mild symptoms. Antibiotics are recommended in all children younger than six months, in those between six months and two years if the diagnosis is certain, and in children with severe infection. High-dosage amoxicillin (80 to 90 mg per kg per day) is recommended as first-line therapy. Macrolide antibiotics, clindamycin, and cephalosporins are alternatives in penicillin-sensitive children and in those with resistant infections. Patients who do not respond to treatment should be reassessed. Hearing and language testing is recommended in children with suspected hearing loss or persistent effusion for at least three months, and in those with developmental problems.

Authors+Show Affiliations

Ramakrishnan K
University of Oklahoma Health Sciences Center, Oklahoma City 73104, USA. kramakrishnan@ouhsc.edu
Sparks RA
No affiliation info available
Berryhill WE
No affiliation info available

MeSH

Acute DiseaseAlgorithmsAmoxicillinAnti-Bacterial AgentsCephalosporinsChildChild, PreschoolClindamycinDiagnosis, DifferentialHaemophilus InfectionsHaemophilus influenzaeHearing LossHumansInfantMoraxella catarrhalisMoraxellaceae InfectionsOtitis MediaOtitis Media with EffusionOtitis Media, SuppurativeOtoscopyPneumococcal InfectionsStreptococcus pneumoniae

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18092706

Citation

Ramakrishnan, Kalyanakrishnan, et al. "Diagnosis and Treatment of Otitis Media." American Family Physician, vol. 76, no. 11, 2007, pp. 1650-8.
Ramakrishnan K, Sparks RA, Berryhill WE. Diagnosis and treatment of otitis media. Am Fam Physician. 2007;76(11):1650-8.
Ramakrishnan, K., Sparks, R. A., & Berryhill, W. E. (2007). Diagnosis and treatment of otitis media. American Family Physician, 76(11), 1650-8.
Ramakrishnan K, Sparks RA, Berryhill WE. Diagnosis and Treatment of Otitis Media. Am Fam Physician. 2007 Dec 1;76(11):1650-8. PubMed PMID: 18092706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis and treatment of otitis media. AU - Ramakrishnan,Kalyanakrishnan, AU - Sparks,Rhonda A, AU - Berryhill,Wayne E, PY - 2007/12/21/pubmed PY - 2007/12/29/medline PY - 2007/12/21/entrez SP - 1650 EP - 8 JF - American family physician JO - Am Fam Physician VL - 76 IS - 11 N2 - Diagnostic criteria for acute otitis media include rapid onset of symptoms, middle ear effusion, and signs and symptoms of middle ear inflammation. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common bacterial isolates from the middle ear fluid of children with acute otitis media. Fever, otalgia, headache, irritability, cough, rhinitis, listlessness, anorexia, vomiting, diarrhea, and pulling at the ears are common, but nonspecific symptoms. Detection of middle ear effusion by pneumatic otoscopy is key in establishing the diagnosis. Observation is an acceptable option in healthy children with mild symptoms. Antibiotics are recommended in all children younger than six months, in those between six months and two years if the diagnosis is certain, and in children with severe infection. High-dosage amoxicillin (80 to 90 mg per kg per day) is recommended as first-line therapy. Macrolide antibiotics, clindamycin, and cephalosporins are alternatives in penicillin-sensitive children and in those with resistant infections. Patients who do not respond to treatment should be reassessed. Hearing and language testing is recommended in children with suspected hearing loss or persistent effusion for at least three months, and in those with developmental problems. SN - 0002-838X UR - https://www.unboundmedicine.com/medline/citation/18092706/Diagnosis_and_treatment_of_otitis_media_ DB - PRIME DP - Unbound Medicine ER -