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Look at AOM as a spectrum of infection
Kalu SU. Pediatr Infect Dis J. 2011;30:95-99.
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Gaining a deeper understanding into the clinical spectrum of acute otitis media diagnosis will be the key to establishing treatment protocols for children with this illness, according to a study published online.
Stella U. Kalu, MD, and colleagues of the University of Texas Medical Branch at Galveston conducted a prospective study of 294 children aged 6 months to 3 years. The researchers recorded otoscopic findings of these children during upper respiratory infections and categorized these findings by tympanic membrane position, color, translucency and mobility.
The researchers said within 1 week of upper respiratory illness infection, about 22% of their study population had AOM and another 7% developed myringitis. Within 1 month of symptom onset, the tympanic membrane was most frequently described as “mild bulging” followed by “bulging” and “nonbulging.” In more than half of the 126 bilateral AOM episodes, inflammation in both tympanic membranes was recorded at different periods of the infection.
The researchers said of the 28 children who had “nonsevere” AOM and were managed using a “watchful waiting” approach, four progressed; three of these later required an antibiotic.
“Understanding the wide clinical spectrum of AOM is needed to help with future clinical trial design and development of a scoring system to establish treatment criteria that will minimize antibiotic use,” the researchers concluded.
Disclosure: The research was supported by an NIH grant.