Nieuwe aanbevelingen voor de behandeling van acute otitis media in de eerste lijn

Abstract

New recommendations for the management of acute otitis media in primary care This article is a summary of the recent clinical guideline update of acute otitis media with recommendations for its diagnosis, treatment and prevention, including complicated acute otitis media or acute otitis media at risk of complications in children and adults in general practice. The clinical practice guideline came about with the participation of all relevant disciplines and according to an internationally recognized methodology for guideline development (Adapte procedure). The elements of the medical history and clinical examination have limited diagnostic value. Moreover, symptoms alone are not enough to make the diagnosis of acute otitis media. The diagnostic hypothesis is based on the combination of these elements. The doctor pays attention to the patient’s experience and provides the necessary information to enable the patient to manage his/her disease properly (e.g. pain management). Shared decision-making is a key point. Antibiotics are justified in case of an unfavorable disease course and in the presence of major risk factors for complications. However, certain subgroups may benefit from antibiotic therapy. Effective pain or fever treatment (with paracetamol or ibuprofen) has become the cornerstone of acute otitis media management. More targeted antibiotic therapy is reserved for specific indications.