Sunday, April 13, 2014

RECENT GUIDELINES ON THE MANAGEMENT OF SECRETORY OTITIS MEDIA



RECENT GUIDELINES ON THE MANAGEMENT OF SECRETORY OTITIS MEDIA

Secretory otitis media is defined as the inflammation of middle ear mucosa, often as a result of obstruction of the eustachian tube and accompanied by accumulation of fluid.It is also known as serous otitis, glue ear or silent ear infection. Symptoms include partial hearing loss, behavioral problems due to the frustration at being unable to hear well.
 2013 revisions for management of otitis media include:
*       Antibiotics should be given for severe cases of bilateral or unilateral acute otitis media for children >6 months based on ear pain that is moderate or severe, lasts for at least 48 hours, or is accompanied by a temperature of >102.2°F.
*      In less severe cases, watchful waiting could be offered instead of antibiotics unless both ears are affected in kids aged 6–23 months.
*      Recurrent acute otitis media is defined as three episodes in six months or four episodes in the prior year with one in the past six months.Prophylactic antibiotics should not be prescribed to reduce recurrences. Instead, these children may be offered the option of tympanostomy tubes.
*      Amoxicillin remains the first-line agent; drugs that have additional beta-lactamase coverage are selected for kids who have already had it in the prior month.
*      Pneumococcal conjugate vaccine and annual flu shots are recommended for all children.
REFERENCE
BelsyBoban  and  Augustine Xavier, Pharm D 4th year. 

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