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Diagnosis and treatment of acute otitis media: review

Published online by Cambridge University Press:  19 July 2012

Edward C Toll  and
Desmond A Nunez
Edward C Toll
Affiliation:
University College London Ear Institute, UK
Desmond A Nunez*
Affiliation:
Academic Department of Otolaryngology/Head and Neck Surgery, ENT Unit, Southmead Hospital, Bristol, UK
*
Address for correspondence: Desmond A Nunez, MD FRCS(ORL) Associate Professor & Head University of British Columbia, Division of Otolaryngology – Head and Neck Surgery, Vancouver Hospital, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC, CanadaV5Z 1M9 E-mail: desmond.nunez@ubc.ca
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Abstract

Background:

Acute otitis media is very common, but diagnostic criteria and treatment recommendations vary considerably.

Methods:

Medline, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were searched using the key words ‘acute otitis media’ AND ‘diagnosis’ OR ‘diagnostic criteria’ OR ‘definition’, and by combining the terms ‘acute otitis media’ AND ‘guidelines’. PubMed was searched using the key words ‘mastoiditis’ and ‘prevalence’.

Results:

The 11 most recently published guidelines unanimously agreed that adequate analgesia should be prescribed in all cases. The majority recommended that routine antibiotic prescription should be avoided in mild to moderate cases and when there was diagnostic uncertainty in patients two years and older. Antibiotics were recommended in children two years and younger, most commonly a 5-day course of amoxicillin (or a macrolide in patients allergic to penicillin).

Conclusion:

Level 1A evidence shows that selected cases of acute otitis media benefit from antibiotic prescription.

Keywords

Otitis MediaPractice GuidelineDiagnosisTherapyMastoiditis
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 976 - 983
Copyright
Copyright © JLO (1984) Limited 2012

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