What about preventive treatment?
We certainly immunize children today
against haemophilus influenzae B
pneumoniae with vaccines.
We do that at the age of
2 and 4 months of age.
We generally do not give long-term antibiotics
to kids who have recurrent
episodes of acute otitis media.
We only invite
resistance and problems.
Tympanostomy tubes are
used fairly frequently
in kids who have lots of
recurrent otitis media.
And they work.
We’re now using the conjugate
vaccine called Prevnar 13,
which is a vaccine against 13
of the most common strains.
It is a conjugate vaccine and of course
annual influenza vaccine is prudent.
Kids who are breastfed have a lower
incidence of acute otitis media.
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
and H influenzae to
respiratory epithelial cells.
So I think you can see that we
concluded that the majority
of cases of acute otitis media
are actually self-limiting.
And 80% improve in 24 to 48 hours and
are symptom-free within several days.
Conductive hearing loss definitely
occurs in acute otitis media,
but it gradually improves and
it’s usually not permanent.
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.
They can get colonization by some bed
bugs that can cause chronic infection.
Kids who attend daycare often
get frequent respiratory
tract infections and as a
result, frequent otitis media.
They can develop chronic
otitis media as well.
People who have nutrition
are more prone.
And those who are chronically
exposed to second hand smoke.
This concludes my discussion
of acute otitis media.
I hope it was helpful.