Title: Otitis Media (submitted by Ari Kestler, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><p>
2013 AAP AOM Guidelines UPDATE</p>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
-AAP released a new clinical practice guideline for diagnosis and management of acute otitis media (AOM).</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
Key Action Statements:</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
<u><strong>Diagnosis </strong></u>if presence of middle ear effusion <u><em><strong>and</strong></em></u></div>
<div style="font-family: arial,sans-serif; font-size: 13px; margin-left: 40px;">
(1) moderate to severe bulging of tympanic membrane (TM) or new otorrhea <u><em><strong>or</strong></em></u></div>
<div style="font-family: arial,sans-serif; font-size: 13px; margin-left: 40px;">
(2) mild bulging of TM <u><strong><em>and</em></strong></u> recent ear pain or intense erythema of TM</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
<u><strong>Treatment </strong>options:</u></div>
<ul>
<li style="font-family: arial,sans-serif; font-size: 13px;">
<em>Severe </em>unilateral or bilateral AOM (>6mo): give antibiotics. <strong>Severe</strong> AOM is defined as fever >102.2 (39 C), moderate/severe otalgia, or symptoms >48h.</li>
<li style="font-family: arial,sans-serif; font-size: 13px;">
<em>Nonsevere </em><u>unilateral </u>AOM (6-23 months): Advise the parents to consider a period of close observation and follow up (24-72h). If the childs clinical status deteriorates give antibiotics.</li>
<li style="font-family: arial,sans-serif; font-size: 13px;">
<em>Nonsevere </em><u><em>bilateral</em></u> AOM (6-23 months): give antibiotics.</li>
<li style="font-family: arial,sans-serif; font-size: 13px;">
<em>Nonsevere </em>unilateral or bilateral AOM (>24 months): Advise the parents to consider a period of close observation and follow up (24-72h). If the childs clinical status deteriorates, give antibiotics.</li>
</ul>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
</div>
<div style="font-family: arial, sans-serif; font-size: 13px; ">
Reference: Pediatrics Vol. 131 No. 3 March 1, 2013</div>