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Abstract

Acute otitis media (AOM) is a very common disease, especially in childhood. It is the most common individual diagnosis
associated with prescribing antibiotic therapy, which is why all doctors who deal with the treatment of this disease have
important recommendations and guidelines for diagnosis and treatment.

These are reviews and recommendations for the diagnosis and treatment of AOM.

The most common bacterial pathogens are Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis.
The use of antipneumococcal vaccine has led to a reduction in the incidence of pneumococcal otitis. About 30% of AOM
is caused by viruses. Recommendations for the choice of first-line antibiotics are amoxicillin and amoxicillin-clavulanate.

Keywords: acute otitis, otitis media, antibiotic, otitis therapy

Literatura 15. Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S,
Shope TR, et al. Shortened Antimicrobial Treatment for Acute Otitis
Media in Young Children. N Engl J Med. 2016 Dec 22;375(25):2446-56.
1. Harbarth S, Balkhy HH, Goossens H, Jarlier V, Kluytmans J, 16. Spoială EL, Stanciu GD, Bild V, Ababei DC, Gavrilovici C. From
Laxminarayan R, et al. Antimicrobial resistance: one world, Evidence to Clinical Guidelines in Antibiotic Treatment in Acute
onefight! Antimicrob Resist Infect Control. 2015 Nov;4:49. Otitis Media in Children. Antibiotics (Basel). 2021 Jan 6;10(1):52.
2. McCullough AR, Pollack AJ, Plejdrup Hansen M, Glasziou PP, Looke 17. Suzuki HG, Dewez JE, Nijman RG, Yeung S. Clinical practice guidelines
DF, Britt HC, et al. Antibiotics for acute respiratory infections in for acute otitis media in children: a systematic review and appraisal of
general practice: comparison of prescribing rates with guideline European national guidelines. BMJ Open. 2020 May 5;10(5):e035343.
recommendations. Med J Aust. 2017 Jul 17;207(2):65-9.
3. Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM 18. Leach AJ, Morris PS, Coates HL, Nelson S, O’Leary SJ,
Jr, et al. Prevalence of Inappropriate Antibiotic Prescriptions Among US Richmond PC, et al. Otitis media guidelines for Australian
Ambulatory Care Visits, 2010-2011. JAMA. 2016 May 3;315(17):1864-73. Aboriginal and Torres Strait Islander children: summary of
recommendations. Med J Aust. 2021 Mar;214(5):228-233.
4. Little P, Moore M, Kelly J, Williamson I, Leydon G, McDermott L, et
al; PIPS Investigators. Delayed antibiotic prescribing strategies for 19. Frost HM, McLean HQ, Chow BDW. Variability in Antibiotic
respiratory tract infections in primary care: pragmatic, factorial, Prescribing for Upper Respiratory Illnesses by Provider
randomised controlled trial. BMJ. 2014 Mar 6;348:g1606. Specialty. J Pediatr. 2018 Dec;203:76-85.e8.
5. McNulty CA, Lecky DM, Hawking MK, Quigley A, Butler 20. Wald ER, DeMuri GP. Antibiotic Recommendations for Acute
Otitis Media and Acute Bacterial Sinusitis: Conundrum No
CC. Delayed/back up antibiotic prescriptions: what do the More. Pediatr Infect Dis J. 2018 Dec;37(12):1255-7.
public think? BMJ Open. 2015 Nov 27;5(11):e009748.
21. Piltcher OB, Kosugi EM, Sakano E, Mion O, Testa JRG, Romano FR,
6. Karma PH, Penttilä MA, Sipilä MM, Kataja MJ. Otoscopic et al. How to avoid the inappropriate use of antibiotics in upper
diagnosis of middle ear effusion in acute and non-acute respiratory tract infections? A position statement from an expert
otitis media. I. The value of different otoscopic findings. panel. Braz J Otorhinolaryngol. 2018 May-Jun;84(3):265-79.
Int J Pediatr Otorhinolaryngol. 1989 Feb;17(1):37-49.
7. Palmu AA, Herva E, Savolainen H, Karma P, Mäkelä PH, Kilpi TM. 22. Sakulchit T, Goldman RD. Antibiotic therapy for children with
Association of clinical signs and symptoms with bacterial findings acute otitis media. Can Fam Physician. 2017 Sep;63(9):685-7.
in acute otitis media. Clin Infect Dis. 2004 Jan 15;38(2):234-42.
8. Kaur R, Morris M, Pichichero ME. Epidemiology of Acute
Otitis Media in the Postpneumococcal Conjugate Vaccine
Era. Pediatrics. 2017 Sep;140(3):e20170181.
9. Brandileone MC, Zanella RC, Almeida SCG, Brandao AP, Ribeiro AF, Konflikt interesa: Nema
Carvalhanas TMP, et al; Pneumococcal Carriage Study Group. Effect of
10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage Primljeno: 26. 02. 2022.
of Streptococcus pneumoniae and Haemophilus influenzae among Prihvaćeno: 12. 04. 2022.
children in São Paulo, Brazil. Vaccine. 2016 Nov 4;34(46):5604-11.
Onlajn: 30. 06. 2022.
10. Grijalva CG, Nuorti JP, Griffin MR. Antibiotic prescription
rates for acute respiratory tract infections in US ambulatory
settings. JAMA. 2009 Aug 19;302(7):758-66.
11. Rosenfeld RM, Vertrees JE, Carr J, Cipolle RJ, Uden DL, Giebink
GS, Canafax DM. Clinical efficacy of antimicrobial drugs for
acute otitis media: metaanalysis of 5400 children from thirty-
three randomized trials. J Pediatr. 1994 Mar;124(3):355-67.
12. Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers
MM. Antibiotics for acute otitis media in children. Cochrane
Database Syst Rev. 2015 Jun 23;2015(6):CD000219.
13. Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman
A, Jackson MA, et al. The diagnosis and management of
acute otitis media. Pediatrics. 2013 Mar;131(3):e964-99.
14. Rovers MM, Glasziou P, Appelman CL, Burke P, McCormick
DP, Damoiseaux RA, Gaboury I, et al. Antibiotics for acute
otitis media: a meta-analysis with individual patient
data. Lancet. 2006 Oct 21;368(9545):1429-35.

98 DOI: 10.5937/Galmed2202095P