Otolaryngology News

Two ear disorders commonly affect children — acute otitis externa and otitis media with effusion requiring tympanostomy tube (TT) insertion. Although TT insertion is not managed by pediatricians, it is the most common ambulatory surgical procedure performed in children, and thus, pediatricians are best informed of recent advances in its associated drug therapies. By contrast, acute otitis externa (AOE) is commonly diagnosed and treated in the pediatrician’s office. This month’s column focuses on the pharmacotherapies used in the treatment of AOE and TT insertion. A more recently FDA-approved product, Otiprio (single-dose ciprofloxacin 6%; Otonomy), is also discussed.

Although ear, nose and throat infections account for a sizable portion of pediatric health care visits, accurate diagnoses and proper antibiotic use are a major concern. Findings published in JAMA found that of the 221 antibiotic prescriptions given per 1,000 patients, only 111 were deemed appropriate as treatments for the patients’ diagnoses.

Infectious Diseases in Children asked Ingrid Camelo, MD, pediatric infectious disease fellow, division of pediatrics infectious diseases at Boston Medical Center, Leslie Grammatico-Guillon, MD, PhD, guest researcher, pediatric infectious diseases, Boston University, and Vishakha Sabharwal, MD, assistant professor of pediatrics and attending physician, pediatrics infectious disease, Boston University School of Medicine, to discuss whether physicians should have to justify their use of antibiotics. Would this be an effective strategy to reduce unnecessary prescribing if included in electronic medical records, and is the potential frustration with the process worth the effort to curb antimicrobial resistance?

Healthy children aged younger than 3 years were at increased risk for post-tonsillectomy complications vs. children aged 3 to 6 years, according to findings recently published in JAMA Otolaryngology Head and Neck Surgery.

Infants who experience bronchiolitis during respiratory syncytial virus season within their first 6 months of life are more likely to have otitis media, pneumonia and use antibiotics regardless of their mother’s asthma status, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology in Orlando.

The FDA placement of a black-box warning on the use of codeine in children after tonsillectomy and/or adenoidectomy was able to decrease the amount of the drug used in the pediatric population after this operation; however, one in 20 are still prescribed the opioid after the operation.

Language outcomes in children with permanent childhood hearing loss are mitigated through the use of early intervention strategies such as early amplification and cochlear implantation once a diagnosis has been made.

Of the children who experienced bone or joint infection, 71% had the identical Kingella kingae bacterium present in their throats, suggesting that children with osteoarticular infections may benefit from examination for oropharyngeal infections to expedite diagnosis.

Although noise exposure does not impact the prevalence of hearing loss in children, racial or ethnic minority status and low socioeconomic status was associated with an increased risk, according to a study published in JAMA Otolaryngology-Head & Neck Surgery

While the incidence and frequency of acute otitis media have decreased significantly following the introduction of pneumococcal conjugate vaccines, risk factors – including day care attendance and family history of the condition – have remained the same.