The diagnosis and management of otitis media in children

Abstract

Otitis media is one of the most common bacterial infectious diseases in children and the most common indication for the prescription of antibiotics in Korea. Otitis media, including acute otitis media (AOM) and otitis media with effusion (OME), is also one of the most common reasons for an illness-related visit to a primary care clinician. The first step in management decisions regarding otitis media must focus on accurate diagnosis to distinguish normal from AOM or OME. In 2010, the Korean Otologic Society published the first version of a set of evidence-based clinical practice guidelines for pediatric otitis media. In 2014, revised clinical practice guidelines were published for otitis media that applied to children under 15 years of age. The guidelines addressed the diagnosis and management of otitis media as well as pain management, choice of antibiotics, and methods for prevention. These guidelines recognized that many episodes of otitis media will resolve on their own without antimicrobial therapy; therefore, one of the recommendations for the initial treatment of otitis media in specified situations is watchful waiting without antibacterial therapy. This study introduces excerpts of the guidelines for the diagnosis and management of otitis media in children. We then briefly discuss the current knowledge about AOM and OME and address the new AOM and OME guidelines point by point. It is important to remember that the actual management of patients with otitis media should depend on the physician's clinical judgment, the symptoms of the individual child, other underlying medical conditions, ready access to adequate follow-up care, and other features.