Concise review for primary-care physicians.

Abstract

Acute otitis media (AOM) in young children consumes a substantial amount of medical care services provided by primary-care physicians. A recent increase in the number of young children with AOM prompted a review of the associated risk factors. Eustachian tube dysfunction, bacterial colonization, and host inflammatory response form the basis for the development of AOM. Signs and symptoms of AOM in young children are often nonspecific and subtle, particularly in infants. Physical examination and pneumatic otoscopy verify the diagnosis. New modalities including tympanometry and acoustic reflectometry may be helpful. Amoxicillin remains the drug of choice for AOM, despite recent trends in microbial resistance. Second- and third-line antimicrobial agents might be considered in selected clinical settings. Young children with recurrent episodes of otitis media must be monitored closely. Preventive measures and medical or surgical intervention should be considered in order to minimize the long-term medical and developmental effects of AOM.