In a Clinical Crossroads article published in the November 27, 2002
issue, Jack L. Paradise, MD, discussed a 15-month-old child who experienced
frequent middle ear infections.1 The patient,
“Sam,” had his first infection at 5 months of age and went on
to have at least 6 more documented episodes of otitis media in the ensuing
6 months. His pediatrician and his parents had elected treatment with prophylactic
amoxicillin.
Paradise discussed the definition of acute otitis media (AOM), its diagnosis
by physical examination of the ear and tympanic membrane, and the epidemiology
and risk factors for recurrent AOM. He reviewed the bacteriology, antibiotic
choice, and duration of treatment for AOM. He discussed evidence-based treatments,
such as prophylactic antibiotics and tympanostomy tubes, and the management
of individual episodes of AOM in children with recurrent infections.