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Pediatr Clin North Am. 2013 Apr;60(2):391-407. doi: 10.1016/j.pcl.2012.12.007.

Otitis media.

Author information

  • 1Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester General Hospital, Rochester, NY 14621, USA. Michael.pichichero@rochestergeneral.org

Abstract

Acute otitis media (AOM) is diagnosed based on visualization of a full or bulging tympanic membrane with middle ear effusion. The distribution of bacteria causing AOM in North America under the influence of pneumococcal conjugate vaccination and antibiotic selection pressure has resulted in a predominance of β-lactamase-producing Haemophilus influenzae followed by penicillin-resistant Streptococcus pneumoniae. Although guidelines continue to endorse amoxicillin as the preferred treatment, amoxicillin/clavulanate in high dosage would be the preferred treatment based on the otopathogen mix currently. Antibiotic prophylaxis has fallen into disfavor as a preventative strategy for AOM recurrences.

Copyright © 2013 Elsevier Inc. All rights reserved.

PMID:
23481107
[PubMed - indexed for MEDLINE]
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