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Effect of patient characteristics and disease manifestations on the outcome of acute otitis media at 2 months.
Arch Fam Med 1993; 2(8):841-6AF

Abstract

BACKGROUND

Optimal therapy for acute otitis media (AOM) is controversial and there is no consensus regarding which antibiotic to use, how long to administer it, or whether antibiotics are effective at all. Knowledge of the effects of patient characteristics and disease manifestations is needed to individualize treatment and to evaluate large-scale trials.

METHODS

Data originated from 2251 patients with AOM, aged newborn to 15 years, who participated in a prospective primary care study in eight countries. At the initial visit, medical history, symptoms, physical findings, and treatment data were recorded. Follow-up 2 months later identified changes in treatment and outcome.

RESULTS

Patients younger than 13 months were less likely to have recovered than those aged 13 months to 15 years (P = .05). Using univariate analysis for infants aged 12 months or younger, male sex, prior episodes of AOM, and serous otitis media were associated with poor outcome. For older patients, poor outcome was associated with initial history of ear tubes, prophylactic antibiotic use, ear discharge, decreased hearing, serous otitis media; and past episodes of AOM; the symptom of decreased hearing; and the finding of pus exuding from the tympanic membrane. Using multivariate analysis for infants aged 12 months or younger, a history of serous otitis media (odds ratio [OR], 2.3; 95% confidence interval [CI], 0.95-5.7), past episodes of AOM (OR, 1.9; 95% CI, 0.82-4.5), and male sex (OR, 1.7; 95% CI, 1.0-3.0) made independent contributions to poor outcome. For children aged 13 months to 15 years, significant variables included pus drainage (OR, 2.2; 95% CI, 1.5-3.3), a history of ear tubes (OR, 2.3; 95% CI, 1.5-3.6), past episodes of AOM (OR, 1.8; 95% CI, 1.3-2.34), and a history of serous otitis media (OR, 1.4; 95% CI, 1.0-1.9).

CONCLUSIONS

Patient characteristics and disease manifestations are significant determinants of AOM outcome.

Authors+Show Affiliations

Department of Family Medicine, Brown University/Memorial Hospital of Rhode Island, Pawtucket.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8111513

Citation

Froom, J, et al. "Effect of Patient Characteristics and Disease Manifestations On the Outcome of Acute Otitis Media at 2 Months." Archives of Family Medicine, vol. 2, no. 8, 1993, pp. 841-6.
Froom J, Culpepper L, Bridges-Webb C, et al. Effect of patient characteristics and disease manifestations on the outcome of acute otitis media at 2 months. Arch Fam Med. 1993;2(8):841-6.
Froom, J., Culpepper, L., Bridges-Webb, C., Bowers, P., Stroobant, A., Lion, J., ... Yodfat, Y. (1993). Effect of patient characteristics and disease manifestations on the outcome of acute otitis media at 2 months. Archives of Family Medicine, 2(8), pp. 841-6.
Froom J, et al. Effect of Patient Characteristics and Disease Manifestations On the Outcome of Acute Otitis Media at 2 Months. Arch Fam Med. 1993;2(8):841-6. PubMed PMID: 8111513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of patient characteristics and disease manifestations on the outcome of acute otitis media at 2 months. A1 - Froom,J, AU - Culpepper,L, AU - Bridges-Webb,C, AU - Bowers,P, AU - Stroobant,A, AU - Lion,J, AU - Rosser,W, AU - Grava-Gubins,I, AU - Grob,P, AU - Yodfat,Y, PY - 1993/8/1/pubmed PY - 1993/8/1/medline PY - 1993/8/1/entrez SP - 841 EP - 6 JF - Archives of family medicine JO - Arch Fam Med VL - 2 IS - 8 N2 - BACKGROUND: Optimal therapy for acute otitis media (AOM) is controversial and there is no consensus regarding which antibiotic to use, how long to administer it, or whether antibiotics are effective at all. Knowledge of the effects of patient characteristics and disease manifestations is needed to individualize treatment and to evaluate large-scale trials. METHODS: Data originated from 2251 patients with AOM, aged newborn to 15 years, who participated in a prospective primary care study in eight countries. At the initial visit, medical history, symptoms, physical findings, and treatment data were recorded. Follow-up 2 months later identified changes in treatment and outcome. RESULTS: Patients younger than 13 months were less likely to have recovered than those aged 13 months to 15 years (P = .05). Using univariate analysis for infants aged 12 months or younger, male sex, prior episodes of AOM, and serous otitis media were associated with poor outcome. For older patients, poor outcome was associated with initial history of ear tubes, prophylactic antibiotic use, ear discharge, decreased hearing, serous otitis media; and past episodes of AOM; the symptom of decreased hearing; and the finding of pus exuding from the tympanic membrane. Using multivariate analysis for infants aged 12 months or younger, a history of serous otitis media (odds ratio [OR], 2.3; 95% confidence interval [CI], 0.95-5.7), past episodes of AOM (OR, 1.9; 95% CI, 0.82-4.5), and male sex (OR, 1.7; 95% CI, 1.0-3.0) made independent contributions to poor outcome. For children aged 13 months to 15 years, significant variables included pus drainage (OR, 2.2; 95% CI, 1.5-3.3), a history of ear tubes (OR, 2.3; 95% CI, 1.5-3.6), past episodes of AOM (OR, 1.8; 95% CI, 1.3-2.34), and a history of serous otitis media (OR, 1.4; 95% CI, 1.0-1.9). CONCLUSIONS: Patient characteristics and disease manifestations are significant determinants of AOM outcome. SN - 1063-3987 UR - https://www.unboundmedicine.com/medline/citation/8111513/Effect_of_patient_characteristics_and_disease_manifestations_on_the_outcome_of_acute_otitis_media_at_2_months_ L2 - https://medlineplus.gov/earinfections.html DB - PRIME DP - Unbound Medicine ER -