Treatment for Acute Inflammation of the middle Ear CONSENSUS STATEMENT

Acute inflammation of the middle ear (also referred to below as " acute otitis media ") is generally defined as acute, short-term, clinically confirmed inflammation in the middle ear. Second to the common cold, acute otitis media is the most common infectious disease among children. Mainly small children are affected; prior to 2 years of age, approximately 50% of children have at least one episode of acute otitis media. The disease is treated by several categories of specialists, mainly general practitioners, pediatricians, and ear, nose, and throat (ENT) specialists. In Sweden, the recommended treatment for purulent, acute otitis media has included antibiotic treatment for all acute ear infections. This practice has been questioned in recent years, in part because resistance to antibiotics has increased among the targeted bacteria. The Swedish Medical Research Council, the Federation of Swe-dish County Councils, and the National Swedish Board of Health and Welfare arranged a consensus development conference on May 10-12, 2000 to reach a consensus on the treatment of acute otitis media in children. The aim of the conference was to agree on recommendations that could be given to all physicians who treat acute otitis media as regards the use of antibiotics and the requirements that should be placed on diagnosis and followup. The questions addressed at the conference were: 1. What causes acute otitis media? 2. How should acute otitis media be diagnosed? 3. How should acute otitis media be managed and followed up? 4. What are the economic consequences of different treatment routines? 5. What information is most urgently needed in research and education? 2 Scope The consensus conference addressed single episodes of acute otitis media in children below 16 years of age. The group of otitis-inclined children, ie, children with recurring acute middle ear infections, was not included. Definitions Acute inflammation of the middle ear (acute otitis media) is defined in this document as a purulent inflammation of the middle ear which has a sudden onset, is of short duration, and can be clinically verified. Mastoiditis refers to the spread of infection beyond the mucous membrane in the middle ear and the cell system with development of osteitis (inflammation in bone tissue). Otitis-inclined child refers to a child who has experienced three or more episodes of acute middle ear inflammation during a 6-month period. Relapse (recurrence) in acute otitis media refers to a new episode within 30 days that occurs after …