Otitis media is a general term for middle ear inflammation with or without symptoms. It can be acute or chronic.
- Two specific diagnoses
- Otitis media with effusion, middle ear effusion (MEE)
- Acute otitis media (AOM)
- Most common condition for which antibacterial agents are prescribed for children in the United States
- Peak incidence between 6 and 12 months of age
- By age 3 years, 50–85% of children have had AOM.
- Age <2 years
- Gender: male > female
- Family history of AOM
- Anatomic differences, craniofacial abnormalities
- Environmental tobacco smoke exposure
- Exposure to large numbers of other children
- Day care
- Siblings in home
- Breastfeeding for at least 3 to 6 months
- Decreasing pacifier use after 6 months
- Pneumococcal conjugate vaccine
- Influenza vaccine
- Reduction in secondhand smoke
- Reduction of day care crowding
- Eustachian tube dysfunction leads to MEE. If effusion is not cleared by the mucociliary system, bacteria and viruses have a good environment for growth.
- Severe eustachian tube dysfunction occurs during 66% of upper respiratory infections (URIs) in school-aged children and in 75% of URIs in day care–aged children.
- Nontypeable Haemophilus influenzae: 35–50%
- Streptococcus pneumoniae: 25–40%
- Moraxella catarrhalis: 5–10%
- Viruses: 40–75%
- High rate of coinfection with bacteria
- Without bacterial coinfection: 5–22%
- Group A Streptococcus (3%)
- Staphylococcus aureus (2%)
- Gram-negative organisms such as Pseudomonas aeruginosa: 1–2%
- More common in neonatal AOM
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