Рациональная терапия острого среднего отита у детей с позиции доказательной медицины

Abstract

Acute otitis media (AOM) is one of the most common diseases in children and adults, as well as the most frequent reasons for prescribing antibacterial therapy (routinely unjustified). The review presents data on the incidence of AOM among the child population in the Russian Federation, discusses the most common viral and bacterial disease pathogens. The review also introduces the term "orthotropic" viral pathogens capable of causing the AOM development with a higher probability. The review discusses the role of microbiota in the AOM development, the difficulties of diagnosis and AOM in children. It also considers the issues of AOM treatment in detail. In clinical practice, preference is given to the combination of lidocaine + phenazone due to the broad evidence base and long-term experience. The recommendation to use topical analgesic drugs as the first-line therapy in AOM during the pre-perforation period of the disease allows to implement a watchful waiting regarding the use of antibacterial drugs, as well as to avoid adverse events of systemic NSAIDs, such as gastrointestinal disorders and nausea. The review focuses on the use of antibiotic therapy in the treatment of AOM. Rational treatment tactics of AOM allows to avoid the development of complications and the inconsistent use of antimicrobials, which will help to prevent bacterial colonization in the nasopharynx and tympanic cavity, as well as the antibiotic resistance development. KEYWORDS: acute otitis media, inflammatory diseases, otopathogen, lidocaine, phenazone, NSAIDs, antibiotic therapy. FOR CITATION: Usenko D.V. Rational therapy of acute otitis media in children based on evidence-based medicine. Russian Journal of Woman and Child Health. 2022;5(3):237–243 (in Russ.). DOI: 10.32364/2618-8430-2022-5-3-237-243.