Some Pediatric Acute Otitis Media Can Be Managed With Close Parental Supervision, Without Antibiotics

MedicalResearch.com Interview with:
Johanna M. Uitti, MD
Department of Paediatrics and Adolescent Medicine
Turku University Hospital
Turku, Finland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: According to several national guidelines, close follow-up is required if initial observation without antimicrobial agents is chosen for the management of acute otitis media (AOM) in children. The aim of this study was to examine whether close follow-up with reexamination is needed for children with AOM initially managed without antimicrobial agents who have symptomatic improvement during the first week after diagnosis, as assessed by their parents.

Of the 104 children with symptomatic improvement, 3 (2.9%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy. In contrast, of the 54 children with symptomatic failure, 16 (29.6%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy.

MedicalResearch.com: What should readers take away from your report?

Response: The resolution of signs of acute otitis media as seen on otoscopy seems to be related to the child’s overall symptomatic condition. Thus, if initial observation without antimicrobial agents is chosen for children with  acute otitis media, close follow-up with reexamination may not be needed for children with symptomatic improvement. Moreover, our results indicate that it seems to be safe to choose the option of initial observation without antimicrobial agents for the management of acute otitis media in children, if the parents can contact the physician whenever necessary.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our study results obligate parents to be the main responsible for observing their child’s well-being, since routine control visits are not needed. However, there are no population-based studies about parents’ attitudes towards their increasing responsibility without a routine control visit.

MedicalResearch.com: Is there anything else you would like to add?

Response: The accurate and careful diagnosis of  acute otitis media, made by the physician, and follow-up of acute otitis media, carried out mainly by the parents and with the help of the physician, are the key elements to the successful management of acute otitis media. It is equally important that the child always receives adequate analgesics.

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