Incidence Of Acute Otitis Media Research Articles

Hubungan Faktor Risiko Eksternal terhadap Kejadian Otitis Media Akut pada Balita di RS Aminah Ciledug

This study examined the correlation of external risk factors to the incidence of AOM in toddlers and preschoolers. This research used an observational analytic design with a cross-sectional approach and data processing uses univariate, bivariate and multivariate analysis. Of the 61 research subjects, the majority of toddlers with AOM were 1-3 years old, 32 children (52.5%), 33 children (54.1%) were female, 37 children (60.7%) had perforation stage. 52 children (85.2%) received exclusive breastfeeding. The results showed that the four variables, including breastfeeding duration, use of pacifiers, PCV vaccinations, and history of ARI (Acute Respiratory Infection), correlated to incidences of acute otitis media. PCV vaccination and history of ARI are the most influencing variables with p-values of 0.024 and 0.006. There is a relationship between external risk factors and the incidence of AOM in toddlers, where the most influential variables are the administration of the PCV vaccine and a history of upper respiratory infection. The researcher of this study suggests at least three doses of PCV vaccination for children at the ages 2, 4, and 6 months, alongside the protection from triggers of ARI to prevent the occurrence of AOM.

Этиология, диа гностика, осложнения и лечение острого среднего отита у детей. Современный взгляд на проблему

The article delves into the etiology, clinical manifestation, diagnosis, and treatment of acute otitis media (AOM), along with measures for preventing its complications. AOM is characterized by the rapid onset of symptoms indicative of inflammation in the middle ear. The paper examines AOM incidence rates across different countries, including Russia, highlighting the significance of this health issue. Various factors can contribute to the development of AOM, such as anatomical features of the middle ear, the cellular biology patterns of the nasopharynx, and variations in immune responses to microbial invasions. The condition is commonly associated with viral and bacterial pathogens, as well as genetic predisposition; however, bacteria are generally considered the primary causative agents. The article also addresses therapeutic approaches and the concern of overdiagnosis, which can lead to the excessive use of antibiotics and subsequent resistance. A retrospective analysis of 90 outpatient records was conducted, focusing on patients who received analgesic ear drops during the pre-perforated stage of AOM. Findings indicate that a combination drug containing lidocaine and phenazone was frequently prescribed in cases of recurrent AOM and for referrals to an otorhinolaryngologist within the initial two days of disease onset, particularly for patients with bilateral AOM. The importance of prompt diagnosis and appropriate treatment of AOM is underscored, as well as the necessity for preventive measures to decrease incidence rates. These insights can be highly beneficial for practitioners and specialists in the field of otorhinolaryngology. KEYWORDS: acute otitis media, otalgia, earache, ear drops, lidocaine, phenazone, compliance, drug choice. FOR CITATION: Kiselyov A.B., Chaukina V.A., Andamova O.V., Avtushko A.S., Vertakova O.V., Rudenskikh Yu.V. Etiology, diagnosis, complications and treatment of acute otitis media in pediatric population. Modern view of the problem. Russian Medical Inquiry. 2024;8(8):493–498 (in Russ.). DOI: 10.32364/2587-6821-2024-8-8-8.

Impact of COVID-19 Pandemic on the Incidence of Pediatric Acute Otitis Media in Seoul, South Korea.

The implementation of nonpharmaceutical interventions (NPIs) for coronavirus disease 2019 (COVID-19) may affect the incidence of infectious diseases. This study aimed to evaluate the changes in the incidence of pediatric acute otitis media (AOM) after the COVID-19 outbreak in Seoul, South Korea. Retrospective cohort. Tertiary referral center. We ascertained the daily number of COVID-19 and pediatric AOM patients between January 20, 2020, and June 19, 2020. During the same period, the number of children using public transportation was used as an index for implementing NPIs. The same period 1 year ago was set as the control period. Diagnostic. The differences in the incidence of AOM and implementation of NPIs between the COVID-19 pandemic and control period were analyzed using segmented regression analyses. Negative values of difference meant that the number in the COVID-19 pandemic period declined compared with the control period. The study period was divided into two sections based on the change point of the COVID-19 cases. In the first period, the increased number of COVID-19 cases decreased, and in the second period, the number of COVID-19 cases increased again. Similar trends were observed in the incidence of AOM and NPI implementation. Before the change point, the study found a significant decreasing trend in the differences in pediatric AOM cases and children using public transportation. However, these trends changed after the change point, with a significant increase in both indices. Our findings indicate that NPIs for COVID-19 may influence the incidence of pediatric AOM.

Acute otitis media in the first two months of life and the impact of pneumococcal conjugate vaccines: A retrospective cohort study.

Information on pneumococcal vaccination's impact on the prevention of acute otitis media (AOM) at very young ages is limited. To define the trends in tympanocentesis-proven AOM incidence, clinical characteristics, microbiology, and antibiotic resistance in infants <2 months of age in southern Israel, before and after the sequential introduction of 7- and 13-valent PCVs. A retrospective population-based cohort study including children <2 months of age diagnosed with AOM at the pediatric emergency room between January 2005-Decmber 2009 (pre-vaccination group, group 1) and January 2013-July 2021 (post-PCV13 introduction, group 2). 160 patients were enrolled, 89 (55.6%) in group 1 and 71 (44.4%) in group 2. The mean incidence of AOM decreased from 1.2 cases/1000 live births for group 1 to 0.45 cases/1000 live births for group 2, P<0.001.130 (81.25%) patients were hospitalized, with higher hospitalization rates in group 1 vs. group 2 (84/89, 94% vs. 46/71, 65%, P<0.001). Hospitalization length was longer in group 1 vs. group 2 (4.07±4.09 days vs. 2.70±1.82 days, P=0.021). Positive MEF cultures were reported in 94/160 (58.75%) patients, with a decrease in positivity rates between the 2 groups (71/89, 80% vs. 23/71, 32%, P<0.001). S. pneumoniae was the most common pathogen (55/94, 58.5%); it was the most frequent pathogen isolated in group 1 (46/71, 65%), and the second most common pathogen in group 2 (9/23, 39%), P=0.03. A significant increase was recorded in the percentages of patients with negative MEF cultures (from 21% to 68%, P<0.001). The introduction and implementation of PCV13 in southern Israel was associated with a decrease in AOM in children <2 months of age and of S. pneumoniae recovery in these patients and was accompanied by less admissions and shorter hospitalizations. An increase in the proportions of negative bacterial cultures from MEF was recorded during the study period.

The effect of pneumococcal conjugated vaccines on occurrence of recurrent acute otitis media among infants diagnosed with acute otitis media at an age younger than 2months.

To examine the impact of pneumococcal conjugate vaccines (PCV) on the occurrence of recurrent acute otitis media (rAOM) among infants diagnosed with an early acute otitis media (AOM) episode. Retrospective cohort study of pediatric patients with a first episode of AOM at an age < 2months. Data included clinical, demographic, and microbiological findings at the first AOM episode. In addition, a 5-year follow-up after the patient's first episode was completed from the medical records. This information included documentation of rAOM episodes and complications of AOM (hearing loss, speech disturbance, mastoiditis, and tympanic membrane perforation) and of ear-related surgical procedures (ventilation tube placement, adenoidectomies, and mastoid surgery). Two groups were studied: patients diagnosed between 2005 and 2009 (representing the unvaccinated group, group 1) and those diagnosed in 2010-2014 (the vaccinated group, group 2). A total of 170 infants were diagnosed with a first AOM episode at an age < 2months; 81 of them belonged to group 1 and 89 to group 2. Streptococcus pneumoniae was isolated in the middle-ear fluid in the first AOM episode in 48.1% of the patients in group 1 and in 30.3% in group 2 (P = 0.0316). 49/81 (60.5%) infants in group 1 were diagnosed with rAOM versus 39/80 (43.8%) in group 2 (P = 0.0298). No statistical differences were found between the groups with respect to long-term complications or need for surgery later in life. Conclusion: Our study showed a significant decrease in the occurrence of rAOM in infants diagnosed with AOM during the first 2months of life and timely immunized with PCVs following this initial AOM episode. What is Known: • 30% of children experience recurrent AOM (rAOM) at the first year of life. The earlier the age of the first AOM, the greater the risk for future complications. • After the introduction of PCVs, the overall pneumococcal AOM incidence declined. We investigated the future effect of PCVs on rAOM occurrence, when administered after the first AOM episode. What is New: • A retrospective cohort of 170 infants with a first AOM episode at an age <2 months and followed for 5 years, showed a significant decrease (28.0%) of rAOM in immunized infants following the initial AOM episode. • Our findings supplement previous data suggesting that the widespread PCVs use prevents rAOM by preventing early AOM and emphasize the importance of timely administration of the PCVs.

Efficacy of Pneumococcal Vaccine on Otitis Media: A Systematic Review and Meta-Analysis.

To assess the effect of the pneumococcal vaccine (PCV) towardthe surgical management and complications of otitis media. MEDLINE, EMBASE, PubMed, Scopus, and clinicaltrial.gov. A systematic search was performed using a combination of keywords and standardized terms about PCV and surgical management or complications of otitis media. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were screened by 3 independent reviewers. Risk of bias assessment, followed by meta-analysis in only randomized-controlled trials was conducted. Vaccine efficacy (VE) and 95% confidence interval (CI) were reported. Of the 2649 abstracts reviewed, 27 studies were included in the qualitative analysis and were categorized into 6 outcomes: tympanostomy tube insertion, otitis media with effusion (OME), mastoiditis, spontaneous tympanic membrane (TM) perforation, recurrent acute otitis media (AOM), and severe AOM. Fifteen studies were included in the meta-analysis to evaluate the rate of tympanostomy tube insertion, OME, and recurrent AOM. PCV was significantly more effective in lowering the rate of tympanostomy tube insertion (VE, 22.2%; 95% CI, 14.6-29.8) and recurrent AOM (VE, 10.06%; 95% CI, 7.46-12.65) when compared with the control group, with no significant difference in reducing the incidence of OME. The qualitative analysis revealed that PCV had efficacy in preventing severe AOM and spontaneous TM perforation but the effect on mastoiditis remained unclear. The PCV was effective in reducing the rate of tympanostomy tube insertion and the incidence of recurrent AOM with a nonsignificant effect in preventing OME in children.

Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England

BackgroundThe 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2006 and the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 in the UK. PCVs are active immunization for the prevention of invasive disease, pneumonia and acute otitis media (AOM) caused by Streptococcus pneumoniae in children.The aim of this observational study was to estimate incidence rates (IRs) of AOM in children ≤17 years from 2003 to 2019 in England, before and after the introduction of pneumococcal conjugate vaccines (PCVs).MethodsAOM episodes were identified using Read diagnosis codes in children aged ≤17 years in the Clinical Practice Research Datalink (CPRD) Gold database from 2003 to 2019. Annual IRs with 95% confidence intervals (CI) by age group were calculated as the number of episodes/person-years (PY) at risk. Interrupted time series analyses were conducted to estimate incidence rate ratios (IRR) across post-PCV7 (2007–2009), early post-PCV13 (2011–2014) and late post-PCV13 (2015–2019) periods compared to the pre-PCV7 period (2003–2005) using generalized linear models.ResultsFrom 2003 to 2019, 274,008 all-cause AOM episodes were identified in 1,500,686 children. The overall AOM IR was 3690.9 (95% CI 3677.1-3704.8) per 100,000 PY. AOM IRs were highest in children aged < 5 years and decreased by age; < 2 years: 8286.7 (95% CI 8216.8-8357.1); 2–4 years: 7951.8 (95% CI 7902.5-8001.4); 5–17 years: 2184.4 (95% CI 2172.1–2196.8) (per 100,000 PY). Overall AOM IRs declined by 40.3% between the pre-PCV7 period and the late-PCV13 period from 4451.9 (95% CI 4418.1-4485.9) to 2658.5 (95% CI 2628.6-2688.7) per 100,000 PY, and across all age groups. IRRs indicated a significant decrease in AOM IRs in all the post-vaccination periods, compared to the pre-PCV7 period: post-PCV7 0.87 (95% CI 0.85–0.89), early post-PCV13 0.88 (95% CI 0.86–0.91), and late post-PCV13 0.75 (95% CI 0.73–0.78).ConclusionsThe AOM IRs declined during the 2003–2019 period; however, the clinical burden of AOM remains substantial among children ≤17 years in England.

Social distancing cut down the prevalence of acute otitis media in children.

To evaluate the additional, unintended benefits of social distancing in cutting down the prevalence of acute otitis media (AOM) in children, especially during coronavirus disease 2019 (COVID-19) periods. The daily outpatient attendance of AOM for childhood (from 6 months to 12 years) was compared in the tertiary hospital in Shanghai during pre-COVID-19 and COVID-19 year. A total of 24,543 AOM cases were included from 2015 to 2020. When age was taken into account, children in kindergarten (aged 4-6) constitute 66.2% (16,236/24,543) of all case, followed by primary school students (6,441/24,543, 26.2%) and preschoolers <3 years old (1,866/24,543, 7.6%). There was an estimated 63.6% (54.32-70.36%) reduction in the daily outpatient attendance of AOM associated with the introduction of social distancing in 2020 (COVID-19 year). The epidemic trend of AOM in 2015-2019 was characterized by seasonal fluctuations, with highest incidence in December (18.8 ± 0.5%) and lower in February (4.5 ± 0.2%), June (3.7 ± 0.7%) and August (3.5 ± 0.5%). And distribution characteristics of different ages in COVID-19 period broadly in line with that in non-pandemic period. Seasonal fluctuation in the prevalence of AOM was observed in pre-COVID-19 period (2015-2019), with a peak in winter and a nadir in summer. The >50% drop of outpatient attendance of AOM in 2020 (COVID-19 year) suggest that social distancing, mask effects and good hand hygiene can significantly reduce the incidence of AOM, which provides a preventive and therapeutic point of view for AOM.

Management of Already Inserted Ventilation Tubes During Pediatric Cochlear Implantation: To Remove or Leave the Tube?

Ventilation tube (VT) insertion is usually recommended before cochlear implantation (CI) in pediatric cochlear implant candidates with recurrent acute otitis media (AOM) or chronic otitis media with effusion (OME). However, there is no consensus on whether the VT is beneficial even after CI, that is, whether the tube should be removed or left in place during CI. This study aimed to assess the effect of tube placement after CI, especially on the incidence of post-CI AOM, in pediatric cochlear implant recipients who had undergone VT insertion before CI because of recurrent AOM or chronic OME. A retrospective medical record review. A tertiary referral cochlear implant center. This study recruited 58 consecutive ears of children who underwent VT insertion followed by CI at age 7 years or younger between 2004 and 2021. Before October 2018, we removed the VT simultaneously with CI (removed group, 39 ears), while since then, the tube has remained in place during CI (retained group, 19 ears). Therapeutic. The primary outcome was the proportion of ears that developed AOM at post-CI 6 months in the removed and retained groups. The age at CI was significantly higher in the removed group than in the retained group (mean [standard deviation]: the removed group, 2.9 [1.2] yr; the retained group: 1.5 [0.8] yr; p < 0.001). The removed group showed a significantly higher proportion of ears with post-CI AOM (8 of 39 ears; 20.5%) than the retained group (none of 19 ears; 0%) 6 months after CI ( p = 0.044). The AOM-free proportion at post-CI 12 months was 76.9% in the removed group and 83.3% in the retained group, demonstrating no significant difference ( p = 0.49), probably because the VT was spontaneously extruded in the retained group at a median of 6.5 months after CI. Throughout the study period, 17 ears (13 from the removed group) were affected by post-CI AOM. Of these, three ears in the removed group and two in the retained group after spontaneous extrusion of the VT were hospitalized and treated with intravenous antibiotics for AOM that had failed to respond to oral antibiotic therapy. Only one ear in the removed group required an explanation of the infected implant. None suffered from chronic perforation of the tympanic membrane or secondary cholesteatoma after VT insertion or meningitis associated with post-CI AOM. Our results suggest that in CI for children who already have a VT because of a recurrent AOM or chronic OME, retaining the tube in position, rather than removing the tube, may decrease the incidence of AOM at least within 6 months after CI, during which most cochlear implant device infection was reported in the pediatric population.

Changing patterns of otitis media in the Waikato region during the COVID-19 pandemic.

Introduction Acute otitis media (AOM) is a common condition of children encountered in general practice. A proportion of children develop otitis media with effusion (OME), which may require tympanostomy and ventilation tube insertion. Aim The aim of the study was to compare the incidence of AOM in Māori and New Zealand (NZ) European children in general practice and the referral practices to secondary care for tympanostomy and ventilation tube insertion. Methods The study was conducted in two parts: (1) an analysis of the incidence of AOM and OME in a rural Waikato general practice (Ōtorohanga) with a high Māori population over a 2-year period; and (2) an analysis of all referrals to the otorhinolaryngology (ORL) department at Waikato District Health Board and tympanostomy and ventilation tube insertion by this service over the same period. Results The incidence of AOM was similar in Māori compared with NZ European children. The incidence declined significantly between 2019 and 2020 and 50% of children with AOM were treated with antibiotics. Referral rates to the ORL department were greater for Māori compared with NZ European children as were tympanostomy and ventilation tube insertion rates. Discussion Although AOM is common, OME was rarely diagnosed. The clinical guidelines regarding antibiotic use for common conditions are not being readily adopted and further research is needed into this matter. The COVID-19 pandemic had a substantial effect on demand both in general practice and in the hospital sector. This may have been due to a reduction in the incidence of AOM or due to system changes caused by the pandemic.

Relationship between cleft palate width and otitis media.

To investigate the relationship between cleft width and otitis media (OM) and to determine whether a wide cleft palate (CP) is a risk factor of the incidence, type, amount of middle ear effusion, and prolonged morbidity in OM. Retrospective cohort study. Children with CP who underwent palatoplasty between 2014 and 2018 were analyzed. Cleft width was measured at palatoplasty. The incidence of otitis media with effusion (OME) and acute otitis media (AOM), the type and amount of middle ear effusion, and OME duration and age at resolution were assessed in relation to cleft width. One hundred eighteen children were included. The CP types were Veau I in 16, II in 35, III in 48, and IV in 19 patients. The incidence of OME and AOM before palatoplasty was 83.1% and 49.2%, respectively. Cleft width did not differ significantly between patients with or without OME but was significantly greater in those with, than in those without, AOM (p < .001), in those with mucoid, than in those with serous, effusion (p=.012), and in those with complete, than in those with partial, effusion (p=.01). Regardless of cleft width or type, OME persisted for a median duration of 50 months. Cleft width was significantly associated with the incidence of AOM and the type and amount of middle ear effusion before palatoplasty. However, it was not significantly related to the incidence, age at resolution, or duration of OME. Regardless of cleft width or type, OM in children with CP requires long-term follow-up. Level of Evidence: 2b.

Risk factors of acute otitis media among infants in a tertiary care hospital in Rawalpindi: a descriptive cross-sectional study

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute otitis media (AOM) is the second most common disease of childhood. Many factors play role in the causation of AOM. However, the research-based data on risk factors for AOM in infants is still inadequate. Objective were this study&lt;strong&gt; &lt;/strong&gt;aimed to determine the risk factors for AOM in infants with AOM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This descriptive cross-sectional study was conducted among 189 infant patients with AOM in the otorhinolaryngology outpatient department of allied hospital of Rawalpindi medical university, Rawalpindi. Established inclusion and exclusion criteria and non-probability convenience sampling technique were utilized for the selection of patients. After taking informed consent, data were collected through a self-adapted questionnaire. Descriptive analysis was accomplished through SPSS version 25.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AOM was more common among patients who had, an age group with a range of 9-12 months (41.28%), male gender (55.02%), lower birth order (49.73%), mothers with illiterate educational status (53.96%), mothers with the job (57.14%), lower socioeconomic status (59.25%), used bottle-feeding (46.56%), supine position during feeding (61.37%), used a pacifier (67.73%), poor feeding hygiene (58.21%), unvaccinated pneumococcal status (57.15%), and large family (63.50%). In the case of family ear infection and passive smoking, AOM incidence was more frequent among infants whose family had no history of ear infection (69.85%) and no smoking exposure (53.44%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In short, the age group with a range of 9-12 months, male gender, low birth order, illiterate mothers, mothers with the job, lower socioeconomic status, bottle-feeding, supine feeding position, pacifier use, poor feeding hygiene, unvaccinated pneumococcal status, and large family size, all raise the risk of AOM incidence in infants.&lt;/p&gt;

Relationship of prolonged pacifier use with acute otitis media

Introduction: The pacifier is defined as an object whose shape is similar to that of a nipple and is made of rubber, making it easier for children to suck, many times it is mothers who include it in breastfeeding without measuring the consequences and effects that it causes with constant use. , affecting health, one of them (Acute Otitis Media). The objective of this systematic review is to determine the relationship between the frequent use of pacifiers and the development of AOM (Acute Otitis Media) in children under 48 months of age. Methods: To carry out the search, the following question was posed: What is the relationship between prolonged pacifier use and otitis media in children under 4 years of age? The search was carried out from May 16 to June 20, 2022. scientific databases reviewed were: PubMed, Ebsco, ScienceDirect, ProQuest and Scopus. To carry out the systematic review, the Boolean operators AND and OR were used, in which three specific combinations (DeCS and MeSH) were used to perform the combinations and execute the search. Results: Initially 1883 were found, but after applying the inclusion and exclusion rules, a total of 45 articles were analyzed. Said reviews began to be reviewed by titles, abstract, and finally, the full text was read, thus leaving only three articles according to the objectives set. Conclusion: The results obtained through this study show the relationship between the prolonged use of the pacifier or pacifier with the development and incidence of AOM (Acute Otitis Media) in children under four years of age, it was possible to observe which is a very frequent emergency in the pediatric population. On the other hand, it is estimated that this population under three years of age has had at least one picture of it, more current studies are required to compare if the incidence statistics of the relationship between pacifier and AOM have been increasing.

Otologic disorders and management strategies in Turner syndrome

Objective: To analyze the incidence and risk factors of otologic disorders in patients with Turner syndrome (TS), so as to provide management strategies for ear health. Methods: This study is a prospective study based on questionnaires and a cross-sectional study. The TS patients who visited our hospital from 2010 January to 2021 March were included (A total of 71 patients with TS were included in this study. the age of TS diagnosed was 3- to 11-year-old, age of visiting ENT department was 4- to 27-year-old) and the incidence of otologic diseases in different age groups was investigated by questionnaires. The cross-sectional study included ear morphology and auditory function assessment, and further analysis of the risk factors that related to ear disease. Prism was used for data analysis. Results: The investigation found that the incidence of acute otitis media in patients aged 3-6 and 7-12 years was higher than that of patients over 12 years old, which was 33.8%(24/71), 42.9%(30/70)and 23.5%(8/34), respectively; 21.1% (15/71) of patients were recurrent acute otitis media in patients aged 3-6 years, and about 46.6% (7/15)of them persisted beyond 6-year. The prevalence of otitis media with effusion in the three groups was 32.4%(23/71), 34.3%(24/70)and 38.2%(13/34), respectively; the recurrence rate of tympanocentesis was 100%(7/7), 42.9%(3/7)and 50.0%(1/2), which was significantly higher than that of grommet insertion. For age groups of 3-6 and 7-12 years, the prevalence of acute otitis media and secretory otitis media was lower in the X chromosome structure abnormal patients; while for patients older than 12 years, otitis media with effusion was the highest prevalence in Y-chromosome-containing karyotypes. In addition, the prevalence of acute otitis media and otitis media with effusion in patients with other system diseases were increased significantly. A cross-sectional study found that 7.0% (5/71)of the lower auricular, 4.2% (3/71)of the external auditory canal narrow, and 38.0% (27/71)of the tympanic membrane abnormality. 35.2%(25/71) had abnormal hearing, including 17 cases of conductive deafness, 6 cases of sensorineural hearing loss, and 2 cases of mixed deafness. The rest of the patients had normal hearing, but 6 of them had abnormalities in otoacoustic emission. Eustachian tube function assessment found that the eustachian tube dysfunction accounted for 38%(27/71). Hearing loss and abnormal Eustachian tube function were not significantly related to karyotype(Chi-square 2.83 and 2.84,P value 0.418 and 0.417), but significantly related to other system diseases(Chi-square 13.43 and 7.53,P value<0.001). Conclusions: The incidence of TS-related otitis media and auditory dysfunction is significantly higher than that of the general population. It not only occurs in preschool girls, but also persists or develops after school age. Accompanied by other system diseases are risk factors for ear diseases. Clinicians should raise their awareness of TS-related ear diseases and incorporate ear health monitoring into routine diagnosis and treatment.

Tympanostomy tubes for children with acute otitis media.

A 30-month-old patient in our clinic has had 4 episodes of acute otitis media (AOM) in the past 6 months. Should I refer the child and family to an ear, nose, and throat surgeon to consider tympanostomy tube placement, or should we continue medical management with antibiotics? Acute otitis media is common among children in Canada, particularly those younger than 3 years of age. Recurrent AOM (3 or more episodes of AOM in a 6-month period or 4 or more episodes of AOM in a 12-month period) is also common in this age group. Routine immunization of infants and children in Canada with pneumococcal conjugate vaccines (initially the 7-valent PCV7 and more recently the 13-valent PCV13) considerably reduced the overall incidence of AOM. Tympanostomy tube placement decreases the incidence of AOM compared with medical management. However, the procedure is no longer superior to medical management after a 2-year period. Both tympanostomy tube placement and medical management are valid options for children with recurrent AOM, and shared decision making with caregivers is recommended.

Antibiotic resistance pattern of Streptococcus pneumoniae among infants younger than six months of age with acute otitis media in Erbil city

Background: Acute otitis media (AOM) is one of the most common inflammatory disorders particularly in infants. Multiple factors such as gender, using bottle-feeding formula, and exposure to cigarette smoking are thought to raise the incidence of AOM. In infants at age six months or less, Streptococcus pneumoniae is the most common causative bacteria of AOM. The complications of pneumococcal infections are due to increasing the rate of antibiotic resistance among the S. pneumoniae strains that coincides with the increased use of antibiotics and multidrug resistant which severely limits the therapeutic options and poses a great threat to public health. Objective: To determine the antibiotic resistance patterns of S. pneumoniae in infants aged six months or less with AOM as the most frequently isolated bacterial pathogens and the most possible risk factors such as parent smoke and bottle feeding that may increase the incidence of acute otitis media in infants. Patients and Methods: A total of 148 infants six months of age or less, 87 males and 61 females with acute otitis media were enrolled in a current study. Swab from ear discharges were collected and cultured. The bacterial isolates were identified and the antibiotic susceptibility pattern for S. pneumoniae isolates was tested. Results: Among the 148 infants studied with acute otitis media, the frequency of the isolated microorganisms from infants with otitis media in male were higher than female and the majority of the infants were bottle feed and who exposed to cigarette smoke at home. S. pneumoniae was comprised the most frequent pathogen (40%) in the selected age, and the antibiotic resistance pattern of 68 S. pneumoniae isolates showed high resistance rate against penicillin, erythromycin and cefalothin. On the other hand, imipenem, vancomycin and chloramphenicol were the most effective drugs against S. pneumoniae isolates. Conclusion: The current study has identified S. pneumoniae as the most causes isolated pathogen in infants at age six months or less with acute otitis media and the majority of bacterial isolates showed a high rate of resistance against antibiotics and the majority of these isolates revealed multi drug resistance phenotype. It has been found that children exposed to passive smoking in the home and who are bottle-fed were at increased risk of acute otitis media . Keywords: Acute otitis media, infants, risk factors, Streptococcus. pneumoniae, multi drug resistance

Incidence of acute otitis media in children\u2009

BackgroundAcute otitis media (AOM) remains a common infection in children despite the introduction of pneumococcal conjugate vaccines. This study estimated AOM incidence rates (IRs) over time in children < 16 years old in Germany following PCV13 introduction.MethodsAOM episodes were identified in the InGef healthcare claims database from 2014–2019 in children aged < 16 years. Each AOM episode was classified as either simple or recurrent. Recurrent AOM was defined as 3 or more episodes identified within a 6-month period; or 4 or more episodes within a 12-month period with at least one episode in the prior 6 months. AOM-related surgical procedures within 12 months and complications within 21 days of an AOM episode were also identified. Annual IRs were calculated as number of episodes/child-years (CY) at risk. 95% Confidence intervals (95%CI) were calculated using the Wilson method. The Mann–Kendall test was used to assess trends over time.ResultsBetween 2014 and 2019, the study population comprised 916,805 children with 327,726 AOM episodes, of which 15% (49,011) of all episodes were identified as recurrent AOM and 85% (278,715) as simple AOM. There were significant declines in AOM (p = 0.003) in the study population overall and in all age groups over the study period; from 101 (95%CI 101–102)/1000 CY to 79 (95%CI 78–80)/1000 CY in the total study population, from 209 (95%CI 206–212)/1000 CY to 147 (95%CI 145–150)/1000 CY in < 2-year-olds, from 239 (95%CI 237–242) to 179 (95%CI 177–182)/1000 CY in 2–4-year-olds, and from 50 (95%CI 49–50) to 38 (95%CI 37–39)/1000 CY in 5–15-year-olds. No significant trends were identified for AOM-related surgical procedures over the study period; however, AOM-related complications overall increased (p = 0.003).ConclusionBetween 2014 and 2019, AOM incidence overall declined in children aged 0–15 years in Germany. Over the study period, the incidence of complicated AOM cases increased, however the incidence of AOM-related surgical procedures remained constant. Despite the impact of PCV13, the burden associated with AOM in Germany remains substantial.

Incidence of acute otitis media in children in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998\u20132018

BackgroundAcute otitis media (AOM) is a leading cause of office visits and antibiotic prescriptions in children. Pneumococcal conjugate vaccines were introduced in the USA in 2000 (7-valent, PCV7) and 2010 (13-valent, PCV13). Expanded valency PCVs are currently under development. To describe the impact of PCVs and quantify the residual burden of AOM, this study estimated annual incidence rates (IRs) of AOM and AOM-related complications and surgical procedures in children < 18 years in the USA before and after the introduction of PCV7 and PCV13.MethodsAOM episodes were identified in the IBM MarketScan® Commercial and Medicaid databases using diagnosis codes (ICD-9-CM: 382.x; ICD-10-CM: H66.xx and H67.xx). Annual IRs were calculated as the number of episodes per 1000 person-years (PYs) for all children < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual AOM IRs were extrapolated using Census Bureau data. Interrupted time series analyses were used to assess immediate and gradual changes in monthly AOM IRs, controlling for seasonality.ResultsIn the commercially insured population, AOM IRs declined between the pre-PCV7 period (1998–1999) and the late PCV13 period (2014–2018) from 1170.1 to 768.8 episodes per 1000 PY for children < 2 years, from 547.4 to 410.3 episodes per 1000 PY in children 2–4 years, and from 115.6 to 91.8 episodes per 1000 PY in children 5–17 years. The interrupted time series analyses indicated significant immediate or gradual decreases in the early PCV7 period (2001–2005), and gradual increases in the late PCV7 period (2006–2009) in children < 2 years; however, crude IRs trended downward in all time periods. In older children, IRs decreased in the early PCV7 and early PCV13 period (2011–2013), but gradually increased in the late PCV7 period. IRs of AOM-related surgical procedures decreased, and IRs of AOM-related complications increased during the study timeframe.ConclusionsAOM disease burden remains high in children of all ages despite overall reductions in AOM IRs during 1998–2018 following the introduction of PCV7 and PCV13. The impact of investigational PCVs on the disease burden of AOM will likely depend on AOM etiology and circulating pneumococcal serotypes.

A Retrospective Database Analysis to Estimate the Burden of Acute Otitis Media in Children Aged

This study aimed to assess trends in the incidence of acute otitis media (AOM), a common childhood condition, following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in the Veneto region of Italy in 2010. AOM episodes (overall, simple, and recurrent (≥3 or ≥4 episodes in 6 or 12 months, respectively, with ≥1 episode in the preceding 6 months)) in children <15 years of age were identified in Pedianet from 2010–2017. Interrupted time series analyses were conducted to assess changes in the annual incidence rates (IRs) in early (2010–2013) and late (2014–2017) PCV13 periods. In total, 72,570 children (402,868 person-years) were identified; 21,048 had 41,683 AOM episodes. Mean annual AOM IR was 103/1000 person-years (95% confidence interval: 102–104), decreasing from 126 to 79/1000 person-years. AOM IRs were highest in children 2–4 years of age, followed by <2 and 5–14 years of age. Overall and simple AOM IRs decreased among children 0–14 years of age, including 2–4 and 5–14 years of age, while recurrent AOM IRs decreased in children <2 years of age. Following PCV13 introduction, AOM IRs decreased substantially in children <15 years of age, with the greatest benefit observed in older children, driven by a reduction in simple AOM IRs. AOM disease burden remains substantial.

Рациональная терапия острого среднего отита у детей с позиции доказательной медицины

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.