Skip to main content
Log in

Therapy of Acute Otitis Media

Clinical and Economic Aspects

  • Review Article
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Abstract

Acute otitis media is a common health problem worldwide that accoun!s for significant morbidity, primarily among pre-school-age children. for which antirnicrobiallhcrapy is currently the treatment of choice. Approximately 25% of all prescriptions wri tten in the US for children under the age of 10 years are for children diagnosed as having acute otitis media. Until adequately designed studies with appropriate patient populations are conducted. clinicians must base their decisions to treat acute otitis media with antimicrobial therapy. and their choice of drug, on local susceptibility patterns (if known), in vitro and in vivo studies. adverse effect profiles, tolerability, and affordability. Such studies will hopefully answer questions about selecting an antimicrobial for acute otitis media and address the comprehensive cost of using various antimicrobials for the condition. Because of the human and economic costs associated with acute otitis media, healthcare practitioners should also be aware of the epidemiology, pathophysiology and various treatment options for children with acute otitis media.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Refernces

  1. Teele DW. Klein JO. Rosner B. et al. Epidelemiology of otitis media during the first seven years of life in children in Greater Boston: a prospective.cohortsudy. J Infect Dis 1989; 160: 83–94

    Article  PubMed  CAS  Google Scholar 

  2. Bluestone CD. Otitis media and sinusitis in children: role of Branhamella catarhallas. Drugs 1986; 31 Suppl.3: 132–41

    Article  Google Scholar 

  3. Daly KA.Epidemiology of otitis media. Otolaryngol Clin North Am 1991: 24: 175–86

    Google Scholar 

  4. Sagraves R. Maish W. Kameshka A. Update on otitis media, Part I: epidemiology and pathophysiology. Am Pharm 1992;32: 27–31

    Google Scholar 

  5. Hueb MM. Ruah C. Definitions and terminology. Otolaryngol Clin North Am 1991: 24: 157–61

    Google Scholar 

  6. Kempthorne J. Giebink GS. Pediatric approach to the diagnosis and managemen of otitis media. Otolaryngol Clin North Am 1991; 24: 905–29

    PubMed  CAS  Google Scholar 

  7. Klein JO. Current issues in upper respiratory tract infections in infants and children: rationale for antibaicterial therapy. Pediatr Infect Dis J 1994: 13 Suppl: 5–8

    Google Scholar 

  8. Klein JO. Teele OW. Pelton SI. New concepts in otitis media: results of investigation, of the Greater Boston Otitis Media Study Group. Adv Pediat. 1992; 39: 127–56

    CAS  Google Scholar 

  9. Kaleida PH. Breast-feeding as preevention for otitis media. Ann otol Rhinol Laryngol 1990: 99 ( 149 Suppl.): 45–7

    Google Scholar 

  10. Lisby-Sutch SM. Nemec-Dwyer MA. Deeter RG.et al. Therapy of otitis media. Clin Pharm 1990; 9: 15–34

    PubMed  CAS  Google Scholar 

  11. Wald ER. Dashefsky B. Byers C. et al. Frequency and severity of infections in day care. J Pediatr 1988; 112: 540–6

    Article  PubMed  CAS  Google Scholar 

  12. Todd NW. Familial predisposition for otitis media in Apache Indians at Canyon day. Arizona.Genet Epidemiol 1981; 4: 25–31

    Article  Google Scholar 

  13. Dugdale AE. Canty A. Lewis AN. et al. The natural history of chronic middle ear disease: in Australian aboriginals: a cross sectional study. Med J Aust 1978: 1 SuppL 1: 6–10

    Google Scholar 

  14. Baxter JD. Chronic otitis media and hearing loss in lhe Eskimo population of Canada. Laryngoscope 1917; 87: 1528–42

    Article  Google Scholar 

  15. Etzel RA. Pattishall EN. Haly NJ. et al. Passive smoking and middle ear effuusion among children in day care, Pediatrics 1992: 90: 228–32

    PubMed  CAS  Google Scholar 

  16. Barnett ED, Klein JO. Pelton SI. et al. Otitis media in children born to human immuno deficiency virus.infected mothers.Pediatr Infeci Dis J 1992: 11:360–4

    Article  CAS  Google Scholar 

  17. Jung TTK. Rhec CK. Otolaryngological approach to the diagnosis and managemenl of otitis media. Otolaryngol Clin Northh Am 1991; 24: 931–45

    CAS  Google Scholar 

  18. Thone DE. Johnson CEo Pharmacotherapy of otitis media. Pharmacotherapy 1991; 11: 212–21

    Google Scholar 

  19. Baquero F. Loza E. Antibiotic resistance of microorganisms involved in ear. nose and throat infections. Pediatr Infect Dis J 1994: 13 Suppl.: 9–14

    Google Scholar 

  20. van Buchern FL, Dunk JH. van Hof MA. Therapy of acute otitis media: myringotomy. antibiotics, or neither? A doubleblind study in childlren. Lancet 1981: 2: 883–7

    Google Scholar 

  21. Froom J. Culpepper L. Grob P. et al. Diagnosis and antibiotic treatment of acute otitis media: report from International Primary care Network. BMJ 1990: 300: 582–5

    Article  PubMed  CAS  Google Scholar 

  22. Burke P, Bain J. Robinson D. et al. Acute red ear in children: controlled trial of non-antibiotic treatment in generic practice.BMJ 1991; 303; 558–62

    Article  PubMed  CAS  Google Scholar 

  23. Kaleida PH, Casselbrant ML, Rockette HE. et al. Amoxicilin or myringotomy or both for acute otitis media: results of arandomized clinical trial. Pediatrics 1991: 81: 466–74

    Google Scholar 

  24. Rosenfidd RM. Vertrees JE. Carr J. et al. Clinical efficacy of amimicrobial drugs for acute Otitis media: metaanalys is of 5400 children from thirty-three randomized trials, J Pediatr1994: 124: 355–67

    Article  Google Scholar 

  25. Chaput de Saintonge OM. Levine OF. Savage IT, et al. Trial of three-day and ten-day courses ofamoxyciliin in otitis media.BMJ 1982; 284: 1078–81

    Article  Google Scholar 

  26. Fliss DM. Leiberman A. Dagan R. Medical sequelae: and complications of acute otitis media. Pediatr Infect Dis J 1994; 13 Suppl: 34–40

    Google Scholar 

  27. Giebink GS. Canafax DM. Kempthorne J, antimacrobial treatment of acute otitis media. J Pediatr 1991; 119: 495–500

    Article  PubMed  CAS  Google Scholar 

  28. Klein JO. Microbiologic efficacy of amibacterial drugs for acute otitis media. Pediatr Infect Dis J 1993: 12: 973–5

    Article  PubMed  CAS  Google Scholar 

  29. Pichicero ME. Assessing the treatment alternatives for acute otitis media. Pediatr Infect Dis J 1994: 13 Suppl.: 27–34

    Google Scholar 

  30. Anonymous. Discussion: otitis media treatment and sequalae. Pediatr Infect Dis J 1994: 13 Suppl.: 50–54

    Google Scholar 

  31. Marchant CD. Carlin SA. Johnsonn CE. et al. Measuring the comparative efficacy of antibacterial agents for acute otitits media:the ‘Pollyanna phenomenon.J Pediatr 1992: 120: 72–7

    Article  PubMed  CAS  Google Scholar 

  32. Howie VM. Owen MJ. Bacteriologic and clinical eficacy of cefixime compared with amoxicillin in acute otitis media.Pediatr Infect Dis J 1987; 6: 989–91

    Article  PubMed  CAS  Google Scholar 

  33. Giebink GS. Ottis media update: pathogenesis and trealment. Ann otol Rhinol Laryngol 1992: 101 Suppl. 155: 21–3

    Google Scholar 

  34. Mandel EM. Rockette HE. Paradise JL. et al. Comparative efficacy of erythromycin-sulfisoxale. cefaclor. amoxicillin or placebo for otitis media in children. Pediatr Infect Dis J 1991:10: 899–906

    Article  PubMed  CAS  Google Scholar 

  35. Hendrickse WA. Kusmiesz H. Shelton S.et al. Five vs. ten days of therapy for acute otitis media. Pediatr Infect Dis J 1988;7: 14–23

    Article  PubMed  CAS  Google Scholar 

  36. Jones R. Bain J. Three-day and seven-day treatment in acute otitis media: I double-blind antibiotic trial. J R Coll Gen Pract 1986: 36: 356–8

    PubMed  CAS  Google Scholar 

  37. Kaprio E. Haapaniemi J. Bondesson G. Clinical efficacy of amoxycillin/clavulanic acid and cefactor in acute Otitis media.Acta Otolaryngol Suppl 1988; 449: 45–6

    Article  PubMed  CAS  Google Scholar 

  38. Meistrup-Larsen KI. Sorensen H. Johnsen NJ. et al. Two versus seven days penicillin treatment for acute otitis media. A placebo controlled trial in children. Acta Otoloryngol 1983: 96:99–104

    Article  CAS  Google Scholar 

  39. Rubenstein MM. McBean JR. Hedgecock LD. et al. The treatment of acute otitis media in children III: a third clinical trial.Am J Dis Child 1965: 109: 308–13

    PubMed  CAS  Google Scholar 

  40. Daniel RR. Comparison of azithromycin and co-amoxidav in the treatment of otitis media in children. J Antimicrob Chemother1993; 31:65–71

    Article  PubMed  Google Scholar 

  41. Molls E. Rodriguez-Solares A. Rivas E. et al. A comparative study of azithromycin and amoxycillin in paediatric patients with acute otitis media. J Antimicrob Chemother 1993: 31 Suppl.E: 73–79

    Google Scholar 

  42. Green SM. Rothrock SG. Singlc-dose intramuscular CefTriaxonE for acute otitis media in children. Pediatrics 1993: 91: 23–30

    PubMed  CAS  Google Scholar 

  43. Gehanno P. Taillebe M. Denis P. et al. Short-course cefotaxime compared with five-day co-amoxyclav in acute otitis media in children. J Antimicrob Chemother 1990; 26: 29–36

    Article  PubMed  Google Scholar 

  44. Feldman W. Momy J. Dulberg C. Trimethoprim-sulfameth oxazole Vs. amoxicillin in the treatment of acute otitis media.Can Med Assoc J 1988; 139: 961–4

    CAS  Google Scholar 

  45. Ruff ME. Schotik DA. Bass JW. et al. Antimicrobial drug suspensions: a blind comparison of baSic of fourtecn common pediatric drugs. Pediatr Infect Dis J 1991; 10: 30–3

    Article  PubMed  CAS  Google Scholar 

  46. Sagraves R. Maish W. Kameshka A. Update on otitis media. Part 2. Treatment. Am Pharm 1993; NS 33: 29–35

    PubMed  CAS  Google Scholar 

  47. Bahal N. Nahata ME. Recent advances in the treatment of otitis media. J Clin Pharm Ther 1992; 17: 201–15

    Article  PubMed  CAS  Google Scholar 

  48. Callahan C Jr. Cost effectiveness of antibiotic therapy for otitis media in a military pediatric clinic. Pediatr Infect Dis J 1988:7: 622–5

    Article  PubMed  Google Scholar 

  49. Weiss JC. Melman ST. Cost effectiveness in the choice of antibiotics for the initial treatment of otitits media in children: a decision analysis approach. Pediatr Infect Dis J 1988: 7: 23–6

    Article  PubMed  CAS  Google Scholar 

  50. Giebink GS. Canafax OM. Antimicrobial treatment of otitis media. Semin Res Ifect 1991; 6: 85–93

    CAS  Google Scholar 

  51. Anonymous. Discussion: 0titis media bacteriotogy and imunology. Pediatr Infect Dis J 1994: 13 Suppl: 2O–22

    Google Scholar 

  52. Wald ER. Antihistamines and decongestants in otitis media. Pediatr Infect Dis J 1984: 3: 386–8

    Article  CAS  Google Scholar 

  53. Sloyer JL. Plussard JH. Howie VM. Efficacy of pneumococcal polysaccharide vaccine in prevention of acute otitits media in infants in Huntsville, Alabama. Rev Infect Dis 1981: 3Suppl.:119–123

    Article  Google Scholar 

  54. Teele OW. Klein JO. Group GBC. er al. Use of pneumococcal vaccine for prevention of recurrent acute otitis media in infants in Boston. Rev Infect Dis 1981: 3 Suppl.: 113–118

    Article  Google Scholar 

  55. Silk HJ. Ambrosino D. Geha RS. Effect of intravenous gamma-globulin therapy in IgG2 deficient and IgG2 sufficient children with recurrent infections and poor response to immunization with Hemophilus influenzae type b capsular polysaccharide antigen. Ann Allergy 1990; 64: 21–5

    PubMed  CAS  Google Scholar 

  56. Bluestone CD. Current management of chronic suppurative otitis media in infants and children. Pediatr Infect Dis J 1988: 7Suppl.: 137–140

    Google Scholar 

  57. Bluestone CD. Modern management of otitis media. Pediatr Clin North Am 1989; 36: 1371–87

    PubMed  CAS  Google Scholar 

  58. Wald ER. Changing trends in the microbiology of otitis media with effusion. Pediatr Infect Dis J 1984; 3: 380–3

    Article  CAS  Google Scholar 

  59. Klein JO. Bluestone CD. Acute otitis media. Pediatr Infect Dis J 1982: 1: 66–73

    Article  CAS  Google Scholar 

  60. Nelson JD. Chronic suppurative otitis media. Pediatr Infect Dis J 1988: 7: 446–8

    Article  PubMed  CAS  Google Scholar 

  61. Alexander DP. Respiratory track infections. In: Young LY. Kodakimble MA. editors. Applied Therapeutics. Vancouver.WA: Applied Therapeutics. Inc:1992

    Google Scholar 

  62. Olin BR. editor. Facts and Comparisons. St.Louis: Facts and Comparisons. Inc:1994

    Google Scholar 

  63. Bergstrom BKV Bertilson SO. Movin G. Clinical evaluation of rectally administered ampicillin in acute otitis media. J Int Med Res 1988: 16: 376–85

    PubMed  CAS  Google Scholar 

  64. Mclinn SE. Serlin S. Cyclacillin veersus amoxicillin as treatment for acute Otitis media. Pediatrics 1983; 71: 196–9

    PubMed  CAS  Google Scholar 

  65. Brodie DP. Griggs JV. Cunningham K. Comparative study of cefuroxime axetil suspension and amoxycillin syrup in treatment of acute otitis media in general practice. J Int Med Res 1990; 18: 235–9

    PubMed  CAS  Google Scholar 

  66. Owen MJ. Anwar R. Nguyen HK et al. Efficacy of cefixime in the treatment of aCute otitis media in children. Am J Dis Child 1993; 147: 81–6

    PubMed  CAS  Google Scholar 

  67. Stutman HR. Comparison of cefprozil and other antibiotic regimens in the treatmenr or children with acute otitis media. Clin Infect Dis 1992: 14 Suppl.2: 204–208

    Article  Google Scholar 

  68. Foshee WS. Loracarbef (LY163892) versus amxicillin-clavulanate in the treatment of bacterial acute otitis media with effusion. J Pediatr 1992: 120: 980–6

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sagraves, R., Maish, W. Therapy of Acute Otitis Media. Pharmacoeconomics 6, 202–214 (1994). https://doi.org/10.2165/00019053-199406030-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00019053-199406030-00004

Keywords

Navigation