Otitis media (acute): antimicrobial prescribing [NG91], NICE (updated 11th March 2022)
This guideline sets out an antimicrobial prescribing strategy for acute otitis media (ear infection). It aims to limit antibiotic use and reduce antimicrobial resistance. Acute otitis media can be caused by viruses or bacteria. It lasts for about a week, and most children get better in 3 days without antibiotics. Serious complications are rare.
In March 2022, we reviewed the evidence and added a recommendation on eardrops containing an anaesthetic and an analgesic because a licensed preparation is now available in the UK. For more information, see update information. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - March 14, 2022 Category: Consumer Health News Source Type: news
ENTs Discourage Ear Tubes for Recurrent AOM Without Effusion ENTs Discourage Ear Tubes for Recurrent AOM Without Effusion
A guideline update reaffirms that tympanostomy tubes should not be considered in children with otitis media without middle ear effusion at the time of assessment for the procedure.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - February 16, 2022 Category: Consumer Health News Tags: Pediatrics News Source Type: news
Treatment Duration for Acute Otitis Media ― So Many Choices Treatment Duration for Acute Otitis Media ― So Many Choices
If antibiotics can do the job in 3 –5 days, why continue antibiotics beyond 5 days?Medscape Pediatrics (Source: Medscape Infectious Diseases Headlines)
Source: Medscape Infectious Diseases Headlines - February 15, 2022 Category: Infectious Diseases Tags: Pediatrics Commentary Source Type: news
Is It or Isn ’ t It Abnormal in This Classification System?
Discussion
Chiari I malformations have caudal displacement of cerebellar tonsils with elongation of the 4th ventricle. It is associated with syringomyelia in up to 80% of patients. Syringomyelia is a cyst-like formation within the spinal cord that contains altered glial elements. This may be asymptomatic or have symptoms occurring from infancy to adulthood. Most patients present in the 3rd decade. Hydrocephalus may be present. A review can be found here.
Classifying information and diseases is important in clinical care as it can help determine treatment and prognosis, and improves communication among clinicians and facili...
Source: PediatricEducation.org - November 8, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are the Clinical Characteristics of the Most Common Skeletal Dysplasia?
Discussion
With more than 200 skeletal dysplasias and multiple variations even for one dysplasia, it can be difficult for the general practitioner to know a lot of specific information about all the skeletal dysplasias. Achondroplasia (ACP) is the most common skeletal dysplasia and specifically short-limbed dwarfism. The incidence is about 1 in 15-40,000 live births. ACP is autosomal dominant with about 80% arising from new mutations with a single nucleotide substitution in the fibroblast growth factor receptor 3 (FGFR3) gene on chromosome 4. This gene regulates the conversion of cartilage to bone, with the problem showing...
Source: PediatricEducation.org - November 1, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Irritability?
Discussion
Child abuse or non-accidental trauma is a clinical diagnosis. It is the constellation of history, physical examination, radiographic evaluation, laboratory testing and investigation that determines if child abuse has occurred. Irritability caused by fractures or other trauma can be a presenting symptom of abuse. Fractures can be a presentation but they are also common problems not associated with abuse. Femoral shaft fractures are estimated to account for only 1.6% of all fractures in children, therefore they are potentially more suspicious for child abuse. A review of femur fractures can be found here. A review...
Source: PediatricEducation.org - October 18, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Is In That Ear?
Discussion
The external auditory canal mainly derives from the ectoderm however it abuts other structures which arise from mesodermal or endodermal tissues. The lateral 1/3 is primarily cartilaginous with the inner 2/3rd being bony with the tympanic, temporal and mastoid bone forming various parts. The canal is lined with squamous epithelium and has various structures such as sebaceous glands, hair follicles and of course ceruminous glands.
It is not surprising that this structure is subject to obstruction given its small size. Cerumen, hair and other cellular debris may become impacted if they are not regularly expelled f...
Source: PediatricEducation.org - October 11, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Causes Facial Pain?
Discussion
Dental caries are one of the most common infections. It is usually caused by Streptococcus viridans. Dental caries are also quite preventable with brushing the teeth at least twice a day with a fluoridated dentifrice, use of dental floss, and preventative dental appointments with application of fluoride varnish and sealants as appropriate. Fluoridated water supplies also help. A review can be found here.
Facial pain is often acute, self-limited and etiologies that may be obvious such as trauma or infection. Facial pain can also overlap with cranial pain (mainly headache), neck pain (often lymphadenopathy or musc...
Source: PediatricEducation.org - October 4, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Secondhand Marijuana Smoke Tied to Respiratory Infections in Children
However, no negative impact seen on emergency department or urgent care visits, otitis media episodes, or asthma exacerbations (Source: Pulmonary Medicine News - Doctors Lounge)
Source: Pulmonary Medicine News - Doctors Lounge - August 10, 2021 Category: Respiratory Medicine Tags: Family Medicine, Infections, Internal Medicine, Pediatrics, Pharmacy, Pulmonology, Anesthesiology & amp; Pain, Journal, Source Type: news
Ear Tubes No Better Than Antibiotics for Otitis Media Ear Tubes No Better Than Antibiotics for Otitis Media
Tympanostomy tubes were not superior to antibiotic treatment for recurrent acute otitis media.Medscape Medical News (Source: Medscape Infectious Diseases Headlines)
Source: Medscape Infectious Diseases Headlines - May 13, 2021 Category: Infectious Diseases Tags: Pediatrics News Source Type: news
Tympanostomy-Tube Placement No Better for Recurrent Otitis Media
THURSDAY, May 13, 2021 -- For young children with recurrent otitis media, the rate of episodes of acute otitis media is not significantly lower with tympanostomy-tube placement versus medical management during the ensuing two-year period, according... (Source: Drugs.com - Pharma News)
Source: Drugs.com - Pharma News - May 13, 2021 Category: Pharmaceuticals Source Type: news
Special Collection - Chronic suppurative otitis media: effectiveness of non-surgical treatments
Supported byCochrane Ear ,Nose and Throat anew Cochrane Library Special Collection curates the latest Cochrane evidence on non-surgical treatments for chronic suppurative otitis media (CSOM). CSOM is estimated to have a global incidence of 31 million episodes per year, disproportionately affecting people at socio-economic disadvantage. Many people who are affected by CSOM do not have good access to modern primary healthcare, let alone specialised ear, nose and throat care. Given this evidence need, Cochrane ENT have prioritized the production of systematic reviews on non-surgical treatments for CSOM. This up-to-date ev...
Source: Cochrane News and Events - March 2, 2021 Category: Information Technology Authors: Muriah Umoquit Source Type: news
Who Gets Pott ’ s Puffy Tumor?
Discussion
Pott’s puffy tumor (PPT) was first described by Sir Percivall Pott in 1775 and who also described other orthopaedic and oncological diseases subsequently named for him. “It is a subperiosteal abscess of the anterior wall of the frontal sinus associated with underlying frontal osteomyelitis.” The tender edema and swelling of the forehead is the sign of PPT. Associated fever, headache, and rhinorrhea along with similar problems such as postnasal drip or nasal congestion are common. Associated ophthalmological problems include peri-orbital or eyelid edema and/or preseptal cellulitis. Ptosis and di...
Source: PediatricEducation.org - March 1, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
What Are Potential Complications of Hearing Aids?
Discussion
Hearing loss can range from profound deafness to fairly minor loss. The causes vary based on age, type of loss (sensorineuronal or conductive, about half of hearing loss in children has a genetic cause), degree and audiometric configuration. Sensorineuronal hearing loss involves the cochlea and neural connections to the brain and auditory cortex. Conductive hearing loss involves structures from the external ear to the oval window. Deafness is defined as a hearing loss > 90 dB. Hearing loss can affect the living and learning of children more than many people realize. “A child with a mild hearing loss can...
Source: PediatricEducation.org - February 1, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
Antibiotic use and serious complications following acute otitis media and acute sinusitis: a retrospective cohort study
Data from patients diagnosed with acute otitis media (AOM) or acute sinusitis (AS) over 20-yr period concludes serious complications (brain abscess/acute mastoiditis) following AOM or AS are rare, and antibiotics are associated with lower odds of developing these complications. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - March 12, 2020 Category: Consumer Health News Source Type: news
