J Korean Med Assoc.  2021 Sep;64(9):624-630. 10.5124/jkma.2021.64.9.624.

Therapeutics for acute otitis media

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Wonkwang University College of Medicine, Iksan, Korea

Abstract

Background
Acute otitis media (AOM) is diagnosed in patients with acute onset of signs and symptoms of inflammation in the middle ear, accompanied by middle ear effusion. AOM is a common infectious disease in children, and its diagnosis and treatment can have significant impacts on the health of children.
Current Concepts
The evidence-based clinical practice guidelines in Korea and other countries provide recommendations to primary care clinicians regarding the management of children with AOM. The treatment strategy for AOM depends on the patient’s age, severity of symptoms, the presence of otorrhea, and the laterality.
Discussion and Conclusion
For children aged from 6-months to 2-years with unilateral non-severe AOM and children aged 2 years or older with unilateral or bilateral non-severe AOM, the published guidelines provide the option of observation rather than immediate treatment with antibiotics. High-dose amoxicillin (80 to 90 mg a day) is the firstline antibiotic for treating AOM in patients without penicillin allergies. Children in whom symptoms persist after 48 to 72 hours of antibiotic treatment should be re-examined and amoxicillin/clavulanate should be used as second-line antibiotics. Careful follow-up is required to identify the complications and sequelae of AOM, and to determine the optimum treatment.

Keyword

Otitis media; Therapeutics; Guideline; Antibiotics; 중이염; 약물치료; 가이드라인; 항생제
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