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    (1st) Wakefield Presentation - Otitis Media

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    heka_amrong
    This document discusses guidelines for the clinical management of otitis media (OM), an ear infection that causes fluid buildup in the middle ear. It covers two types of OM - acute otitis media (AOM), which involves signs of ear inflammation, and otitis media with effusion (OME), which has fluid without symptoms. For OME cases not at high risk, the guidelines recommend a 3-month watchful waiting approach since 75-90% resolve spontaneously. Antibiotics, decongestants, antihistamines, and corticosteroids are not recommended for routine OME treatment due to lack of long-term efficacy and risk of side effects.

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    (1st) Wakefield Presentation - Otitis Media

    Uploaded by

    heka_amrong
    28 views8 pages
    This document discusses guidelines for the clinical management of otitis media (OM), an ear infection that causes fluid buildup in the middle ear. It covers two types of OM - acute otitis media (AOM), which involves signs of ear inflammation, and otitis media with effusion (OME), which has fluid without symptoms. For OME cases not at high risk, the guidelines recommend a 3-month watchful waiting approach since 75-90% resolve spontaneously. Antibiotics, decongestants, antihistamines, and corticosteroids are not recommended for routine OME treatment due to lack of long-term efficacy and risk of side effects.

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    (1st) Wakefield Presentation- Otitis Media

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    This document discusses guidelines for the clinical management of otitis media (OM), an ear infection that causes fluid buildup in the middle ear. It covers two types of OM - acute otitis media (AOM), which involves signs of ear inflammation, and otitis media with effusion (OME), which has fluid without symptoms. For OME cases not at high risk, the guidelines recommend a 3-month watchful waiting approach since 75-90% resolve spontaneously. Antibiotics, decongestants, antihistamines, and corticosteroids are not recommended for routine OME treatment due to lack of long-term efficacy and risk of side effects.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    28 views8 pages

    (1st) Wakefield Presentation - Otitis Media

    Uploaded by

    heka_amrong
    This document discusses guidelines for the clinical management of otitis media (OM), an ear infection that causes fluid buildup in the middle ear. It covers two types of OM - acute otitis media (AOM), which involves signs of ear inflammation, and otitis media with effusion (OME), which has fluid without symptoms. For OME cases not at high risk, the guidelines recommend a 3-month watchful waiting approach since 75-90% resolve spontaneously. Antibiotics, decongestants, antihistamines, and corticosteroids are not recommended for routine OME treatment due to lack of long-term efficacy and risk of side effects.

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    Otitis Media:

    Clinical Practice Guidelines


    and Current Management

    Tamekia L. Wakefield, MD
    Pediatric Otolaryngologist
    ENT & Allergy Associates, LLP
    OME: the presence of fluid in the middle
    ear without acute signs or symptoms

    AOM: the presence of fluid in the middle


    ear with the acute onset of signs and
    symptoms of middle ear inflammation.
    Microbiology/Virology
    S. pneumoniae - 30-35%
    H. influenzae - 20-25%
    M. catarrhalis - 10-15%
    Group A strep - 2-4%
    Infants with higher incidence of gram negative
    bacilli
    RSV - 74% of middle ear isolates
    Rhinovirus
    Parainfluenza virus
    Influenza virus
    Acute otitis media
    Clinical Indicators: Myringotomy and Tubes:

    Severe acute otitis media (myringotomy)


    Poor response (describe) to antibiotic for otitis media
    (myringotomy or tube)
    Impending mastoiditis or intra-cranial complication due
    to otitis media (myringotomy)
    Recurrent episodes of acute otitis media (more than 3
    episodes in 6 months or more than 4 episodes in 12
    months) (tympanostomy tube)
    Eustachian tube dysfunction
    Post-AOM
    Clinicians should manage the child with OME who
    is not at risk with watchful waiting for 3 months
    from the date effusion onset (if known) or from
    the date of diagnosis (if onset is unknown).
    Recommendation
    OME is usually self-limited
    75%-90% of OME after AOM resolves
    spontaneously by 3 months
    Waiting results in little harm to child
    Optimize listening and learning environment
    until effusion resolves
    Antihistamines and decongestants are
    ineffective for OME and are not
    recommended for treatment. Antimicrobials
    and corticosteroids do no have long-term
    efficacy and are not recommended for
    routine management. Recommendation
    Against
    Short-term, small magnitude benefits
    Significant adverse effects
    OME > 4 months with persistent hearing
    loss
    Recurrent or persistent OME in at risk child
    OME with structural damage to TM or ME

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