Treatment Of Recurrent Acute Otitis Media Research Articles

Current views on the treatment and prevention of recurrent acute otitis media in children (review of clinical recommendations)

Recurrent acute otitis media (RAOM) represents at least 3 or more separate episodes of acute otitis media within 6 months or four or more episodes over a 12-month period. The incidence of recurrent otitis media varies from 5 to 30% and does not tend to decrease. Until now, the questions of conservative and surgical treatment of patients remain unsolved. One of the main methods of treatment is antimicrobial therapy. Recently, the treatment of recurrent otitis media is complicated by the increasing acquired resistance of bacteria to antimicrobial drugs. There is also no consensus on the need for and scope of surgical interventions for children with RAOM. The authors in their article cite existing modern approaches to the prevention and treatment of RAOM in children.

Recurrent acute otitis media: a survey of current management in England.

Recurrent acute otitis media is common in children. The preferred treatment measures for recurrent acute otitis media have a mixed evidence base. This study sought to assess baseline practice across ENT departments in England. A national telephone survey of healthcare staff was conducted. Every ENT centre in England was contacted. A telephone script was used to ask about antibiotic and grommet use and duration in recurrent acute otitis media cases. Ninety-six centres (74 per cent) provided complete information. Recurrent acute otitis media treatment across England by ENT departments varied. The antibiotic first- and second-line prophylaxis offered varies, with trimethoprim used in 33 centres and 29 centres not offering any antibiotics. The timing or choice about when to use grommets also varies, but 87 centres (91 per cent) offer grommet surgery at one stage. The treatments received by children in England for recurrent acute otitis media vary by centre; collaborative research in this area is advised.

The modern possibilities of diagnostics and treatment of recurrent otitis media in children

The incidence of recurrent acute otitis media (RAOM) is between 5-30% of the population and has no tendency to decrease. The purpose of this study was to improve the efficiency of diagnosis and treatment of RAOM in children. In carrying out this work were as follows: to establish the incidence of herpes simplex virus, Epstein-Barr virus, cytomegalovirus in children with recurrent otitis media, define the clinical features of RAOM in children with identified markers of active herpes infection and develop an algorithm for the diagnosis and treatment children with recurrent otitis media and markers of active herpes infection. According to the survey markers of herpes infections in children with RAOM identified in 63,8% of cases, mainly active EBV infection is diagnosed – 46,7%. The clinical picture of RAOM in children with markers of active herpes infection characterized by a prolonged course of the disease for more than 7 days – 96,7% (p < 0,05), intoxication more than 3 days – 93,3% (p < 0,05) , obstruction of nasal breathing – in 80,0% (p < 0,05), regional lymphadenitis – in 76.7% of cases (p <0,05), the reaction temperature 38–39 ° C – in 63,3% of cases (p < 0,05). We have developed an algorithm of diagnosis and treatment of children with recurrent otitis media with identified markers of active herpes infection allows to conduct the anti-viral therapy and prevent complications.

Otitis media health status evaluation: a pilot study for the investigation of cost-effective outcomes of recurrent acute otitis media treatment.

There are no reliable and valid instruments that measure otitis media clinical or functional health status in children ages 1 to 3 years. This study develops and tests three new instruments of clinical and functional otitis health status: the Otitis Media Clinical Severity Index (OM-CSI), the Otitis Media Functional Status Questionnaire (OM-FSQ), and the Otitis Media Diary (OMD). The OM-CSI was found to be a reliable measure of clinical acute otitis media (AOM) severity, with high internal consistency (Cronbach's alpha) scores, as well as an accurate indicator of AOM severity. The OM-FSQ and OMD were demonstrated to be reliable and valid measures of otitis-specific functional health status, with reproducible scores over time, high internal consistency alpha scores, and high correlation with measures of AOM clinical severity and other functional health status instruments. These three new instruments were also sensitive and specific indicators of AOM episodes.