Severe acute otitis media in children.

Acute otitis media (AOM) is one of the most common infections in children. Recently it was noticed that there is a marked increase in relapse of severe acute otitis media in children. There is also an increase in number of hospitalized children due to severe AOM, with etiological agent resistant to antibiotics. There is a rise of infections, caused by highly resistant Streptococcus pneumoniae, too. Authors retrospectively reviewed children hospitalized at the Children's ENT Department in Children's University Hospital in Bratislava, from January 2005 to December 2006, due to severe acute otitis media. They mainly focused on etiological agent, antibiotics resistance as well as alternatives of treatment and prevention of severe AOM. During 2 years, there were 76 children aged from 4 months to 14 years hospitalized with severe AOM. The most frequent etiological agent was Streptococcus pneumoniae in 37 cases; this was almost in 70% of cases resistant to routine antibiotics. In 7 cases there was mastoiditis, and mastoidectomy or antrotomy had to be done in 6 cases. To establish a diagnosis and start appropriate treatment it is necessary to identify etiological agent and its sensitivity. An increasing bacterial resistance is forcing us to prescribe antibiotics rationally. When severe AOM occurs, tympanotomy and insertion of ventilation tubes, exceptionally mastoidectomy, is often required (Fig. 13, Tab. 3, Ref. 18). Full Text (Free, PDF) www.bmj.sk.