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Otitis media: diagnosis and treatment.

Abstract

Acute otitis media is diagnosed in patients with acute onset, presence of middle ear effusion, physical evidence of middle ear inflammation, and symptoms such as pain, irritability, or fever. Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Management of acute otitis media should begin with adequate analgesia. Antibiotic therapy can be deferred in children two years or older with mild symptoms. High-dose amoxicillin (80 to 90 mg per kg per day) is the antibiotic of choice for treating acute otitis media in patients who are not allergic to penicillin. Children with persistent symptoms despite 48 to 72 hours of antibiotic therapy should be reexamined, and a second-line agent, such as amoxicillin/clavulanate, should be used if appropriate. Otitis media with effusion is defined as middle ear effusion in the absence of acute symptoms. Antibiotics, decongestants, or nasal steroids do not hasten the clearance of middle ear fluid and are not recommended. Children with evidence of anatomic damage, hearing loss, or language delay should be referred to an otolaryngologist.

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  • Authors+Show Affiliations

    ,

    University of Michigan, Ann Arbor, MI, USA.

    , , , ,

    Source

    American family physician 88:7 2013 Oct 01 pg 435-40

    MeSH

    Acute Disease
    Adult
    Analgesics
    Anti-Bacterial Agents
    Child
    Child, Preschool
    Combined Modality Therapy
    Humans
    Infant
    Infant, Newborn
    Middle Ear Ventilation
    Otitis Media
    Otitis Media with Effusion
    Recurrence
    Risk Factors
    Watchful Waiting

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    24134083

    Citation

    Harmes, Kathryn M., et al. "Otitis Media: Diagnosis and Treatment." American Family Physician, vol. 88, no. 7, 2013, pp. 435-40.
    Harmes KM, Blackwood RA, Burrows HL, et al. Otitis media: diagnosis and treatment. Am Fam Physician. 2013;88(7):435-40.
    Harmes, K. M., Blackwood, R. A., Burrows, H. L., Cooke, J. M., Harrison, R. V., & Passamani, P. P. (2013). Otitis media: diagnosis and treatment. American Family Physician, 88(7), pp. 435-40.
    Harmes KM, et al. Otitis Media: Diagnosis and Treatment. Am Fam Physician. 2013 Oct 1;88(7):435-40. PubMed PMID: 24134083.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Otitis media: diagnosis and treatment. AU - Harmes,Kathryn M, AU - Blackwood,R Alexander, AU - Burrows,Heather L, AU - Cooke,James M, AU - Harrison,R Van, AU - Passamani,Peter P, PY - 2013/10/19/entrez PY - 2013/10/19/pubmed PY - 2013/12/16/medline SP - 435 EP - 40 JF - American family physician JO - Am Fam Physician VL - 88 IS - 7 N2 - Acute otitis media is diagnosed in patients with acute onset, presence of middle ear effusion, physical evidence of middle ear inflammation, and symptoms such as pain, irritability, or fever. Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Management of acute otitis media should begin with adequate analgesia. Antibiotic therapy can be deferred in children two years or older with mild symptoms. High-dose amoxicillin (80 to 90 mg per kg per day) is the antibiotic of choice for treating acute otitis media in patients who are not allergic to penicillin. Children with persistent symptoms despite 48 to 72 hours of antibiotic therapy should be reexamined, and a second-line agent, such as amoxicillin/clavulanate, should be used if appropriate. Otitis media with effusion is defined as middle ear effusion in the absence of acute symptoms. Antibiotics, decongestants, or nasal steroids do not hasten the clearance of middle ear fluid and are not recommended. Children with evidence of anatomic damage, hearing loss, or language delay should be referred to an otolaryngologist. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/24134083/full_citation L2 - http://www.aafp.org/link_out?pmid=24134083 DB - PRIME DP - Unbound Medicine ER -