#Apr and ear practice problems update

Acute otitis media (AOM most common) is characterised by acute inflammation and effusion of the middle ear with rapid onset of symptoms and signs consistent with an ear infection.There are three main categories of otitis media: 2 Children also have larger adenoids than adults when they swell, the eustachian tubes become blocked, making fluid drainage from the middle ear difficult. Otitis media is most common in early childhood due to anatomically shorter and more horizontal eustachian tubes pathogens can enter the middle ear from the nasopharynx more easily and subsequently cause infection. Streptococcus pneumoniae, non-typeable Haemophilus influenzae, Moraxella catarrhalis), or a combination of both. respiratory syncytial virus, rhinovirus, influenza viruses, adenovirus) or bacterial infection (e.g. Otitis media is characterised by middle ear and tympanic membrane inflammation resulting from an upper respiratory tract infection due to viral (e.g. Annual influenza vaccination may be useful to reduce the likelihood of developing severe upper respiratory tract infections.The higher dose is used to treat children with severe or persistent infection.

#Apr and ear practice problems update

Minor update to recommended amoxicillin dose: if antibiotics are indicated, the recommended regimen for amoxicillin is now 15 – 30 mg/kg/dose, three times daily, for five to seven days.

Evidence that air pollution and male sex are risk factors for the development of otitis media.

This is a revision of a previously published article.

Serious complications from otitis media are rare and do not differ in incidence between children who receive antibiotics immediately or delayed.

≥ 3 episodes of AOM within six months or ≥ 4 episodes within 12 months

Also consider antibiotics in children with recurrent infections, i.e.

If there has been no improvement within 48 hours.Tympanic membrane perforation and/or otorrhoea.Aged Consider antibiotics early in children at high risk or who have red flags, e.g.Antibiotics are usually unnecessary as most infections are self-limiting a watchful waiting approach for 24 – 48 hours is recommended before considering antibiotics, except in children at high risk.An analgesic, such as paracetamol or ibuprofen, is the first-line treatment, if required.AOM should be managed on a case-by-case basis, considering factors such as age, infection severity, whether infection is unilateral or bilateral and previous history of otitis media.AOM can be diagnosed based on acute onset of otalgia and fever, supported by evidence of middle ear inflammation and effusion on examination symptoms may be less specific in children aged under two years.Chronic suppurative otitis media (CSOM): chronic inflammation of the middle ear and mastoid cavity, characterised by otorrhoea through a perforated tympanic membrane or grommet – and otitis externa has been excluded.Otitis media with effusion (OME): middle ear effusion without symptoms and signs of an acute ear infection.Acute otitis media (AOM most common): acute inflammation and effusion of the middle ear, with rapid onset of symptoms and signs consistent with an ear infection in younger children, symptoms may be non-specific.Otitis media is defined as inflammation of the middle ear and is classified into three categories:.