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Acute Otitis Media (Middle Ear Infection): Etiology and Prognosis

by John Fisher, MD
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    00:01 What about preventive treatment? We certainly immunize children today against haemophilus influenzae B and streptococcus pneumoniae with vaccines.

    00:14 We do that at the age of 2 and 4 months of age.

    00:21 We generally do not give long-term antibiotics to kids who have recurrent episodes of acute otitis media.

    00:29 We only invite resistance and problems.

    00:34 Tympanostomy tubes are used fairly frequently in kids who have lots of recurrent otitis media.

    00:42 And they work.

    00:45 Pneumococcal vaccine.

    00:49 We’re now using the conjugate vaccine called Prevnar 13, which is a vaccine against 13 of the most common strains.

    01:01 It is a conjugate vaccine and of course annual influenza vaccine is prudent.

    01:07 Kids who are breastfed have a lower incidence of acute otitis media.

    01:16 And a curious benefit is that of Xylitol chewing gum or lozenges for kids obviously are not in danger of choking on it greater than 2 years of age and it does decrease the adherence of streptococcus pneumoniae and H influenzae to respiratory epithelial cells.

    01:38 So I think you can see that we concluded that the majority of cases of acute otitis media are actually self-limiting.

    01:47 And 80% improve in 24 to 48 hours and are symptom-free within several days.

    01:56 Conductive hearing loss definitely occurs in acute otitis media, but it gradually improves and it’s usually not permanent.

    02:05 Now chronic otitis media is uncommon, but can occur as a result of multiple episodes of acute otitis media and we have to watch out for it in kids who’ve got tympanostomy tubes.

    02:19 They can get colonization by some bed bugs that can cause chronic infection.

    02:25 Kids who attend daycare often get frequent respiratory tract infections and as a result, frequent otitis media.

    02:35 They can develop chronic otitis media as well.

    02:39 People who have nutrition are more prone.

    02:43 And those who are chronically exposed to second hand smoke.

    02:50 This concludes my discussion of acute otitis media.

    02:54 I hope it was helpful.


    About the Lecture

    The lecture Acute Otitis Media (Middle Ear Infection): Etiology and Prognosis by John Fisher, MD is from the course Upper Respiratory Infections.


    Included Quiz Questions

    1. HIB vaccine, PCV-13, Prevnar 13
    2. HIB vaccine and MMR
    3. PCV-13 and Prevnar only
    4. Rotovirus vaccine and HIB
    5. Tdap, HIB, PCV 13, and Prevnar
    1. Breastfeeding for at least 4 to 6 months
    2. Chewing bubble gum
    3. Ear candling
    4. Regular day-care education
    5. Cleaning ears with cotton swabs after daily baths
    1. Tympanostomy tube colonization, day-care, poor nutrition, and second hand smoke only
    2. Poor nutrition and second hand smoke only
    3. Vaccinations weakening his immune system at such a young age, gum-chewing, and poor nutrition
    4. Day-care, vaccinations, tympanostomy tubes, and second hand smoke
    5. Day-care, second hand smoke, and poor nutrition, and gum-chewing only

    Author of lecture Acute Otitis Media (Middle Ear Infection): Etiology and Prognosis

     John Fisher, MD

    John Fisher, MD


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