1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania
Acute otitis media (AOM) is an infection of the middle ear. This disease is prevalent all over the world. AOM can affect adults, but they are much more common in children. Smoking, public daycare with >10 children in a group, positive family history, recurrent upper respiratory tract infection, gastro-oesophageal reflux disease are risk factors of AOM. Several studies provided evidence of genetics playing a significant role in the susceptibility to AOM. AOM are caused by bacteria or viruses. Pathogens found in AOM infections: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrahalis, Streptococcus pyogenes, Staphylococcus aureus and human rhinovirus influenza viruses, respiratory syncytial virus, adenovirus and enterovirus. AOM often occur secondary to acute upper respiratory tract infections. The most common symptoms of AOM are earache, fever, reduced hearing, headache, otorrhea. The diagnosis made on the basis of clinical symptoms and otoscopy findings. Otoscopy is essential for a full evaluation. Otoscopic findings of inflammation in AOM may include bulging of the tympanic membrane, decreased mobility of the tympanic membrane. If the eardum is perforated, pus can be observed in the outer ear canal. Management of AOM should begin with adequate analgesia. Antibiotics are not needed in all cases. Antibiotic therapy can be deferred in children two years or older with mild symptoms. The most common antibiotic for AOM is amoxicillin. From the results of animal study, it can be suggested that beta-glucan, in combination with antibiotics, may provide a successful alternative treatment for AOM. Adequate treatment of AOM results in resolution of symptoms and prevention of complications such as reduced hearing, perforation of ear drum, mastoiditis, facial nerve palsy, labyrinthitis, Gradeningo’s syndrome, neck abscesses, meningitis, extradural/subdural abscess, otogenic hydrocephalus. Pneumococcal conjugate vaccine is one of the preventive measures.
Keywords: acute otitis media, antibiotic therapy, pneumococcal conjugate vaccine.