Acute Otitis Media

Dickson, Gretchen

doi:10.1016/j.pop.2013.10.002

Cited by 28 publications

(22 citation statements)

References 31 publications

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“…AOM constitutes the prime indication for antibiotic prescription in infants,20 21 hence pneumococcal vaccination by reducing the number of AOM cases could play a role in limiting the development of antibiotic resistance. In a cluster-randomised, double-blind trial, Palmu et al 80 reported that the use of PHiD-CV vaccine in Finland could result in yearly 12 000 fewer outpatient antibiotic purchases for AOM in children aged <2 years.…”

Section: Discussionmentioning

confidence: 99%

“…17 Furthermore, in contrast to PCV-7 and PCV-13, PHiD-CV has the additional potential to target NT Hi -related AOM, due to the employment of protein D derived from NT Hi as a carrier protein for the majority of its conjugates 1819 This is important, as AOM represents a major indication for the prescription of antibiotics in infants 2021 Significant antibiotic resistance has been observed in Sp 22–24 and NT Hi bacteria,25 and the increasing resistance to antibiotics is globally recognised as a health policy concern.…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model

Delgleize

Leeuwenkamp²,

Theodorou³

et al. 2016

BMJ Open

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ObjectivesIn 2010, the 13-valent pneumococcal conjugate vaccine (PCV-13) replaced the 7-valent vaccine (introduced in 2006) for vaccination against invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) in the UK. Using recent evidence on the impact of PCVs and epidemiological changes in the UK, we performed a cost-effectiveness analysis (CEA) to compare the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with PCV-13 in the ongoing national vaccination programme.DesignCEA was based on a published Markov model. The base-case scenario accounted only for direct medical costs. Work days lost were considered in alternative scenarios.SettingCalculations were based on serotype and disease-specific vaccine efficacies, serotype distributions and UK incidence rates and medical costs.PopulationHealth benefits and costs related to IPD, pneumonia and AOM were accumulated over the lifetime of a UK birth cohort.InterventionsVaccination of infants at 2, 4 and 12 months with PHiD-CV or PCV-13, assuming complete coverage and adherence.Outcome measuresThe incremental cost-effectiveness ratio (ICER) was computed by dividing the difference in costs between the programmes by the difference in quality-adjusted life-years (QALY).ResultsUnder our model assumptions, both vaccines had a similar impact on IPD and pneumonia, but PHiD-CV generated a greater reduction in AOM cases (161 918), AOM-related general practitioner consultations (31 070) and tympanostomy tube placements (2399). At price parity, PHiD-CV vaccination was dominant over PCV-13, saving 734 QALYs as well as £3.68 million to the National Health Service (NHS). At the lower list price of PHiD-CV, the cost-savings would increase to £45.77 million.ConclusionsThis model projected that PHiD-CV would provide both incremental health benefits and cost-savings compared with PCV-13 at price parity. Using PHiD-CV could result in substantial budget savings to the NHS. These savings could be used to implement other life-saving interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model

Delgleize

Leeuwenkamp²,

Theodorou³

et al. 2016

BMJ Open

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“…Otitis media (OM) refers to a group of complex infectious and inflammatory diseases affecting the middle ear (Dickson, 2014). OM in general is very common, as studies show that around 80 % of children should have experienced at least one episode by their third birthday (Teele et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Mittal

Lisi

Gerring

et al. 2015

Journal of Medical Microbiology

190

161

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Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss. IntroductionOtitis media (OM) refers to a group of complex infectious and inflammatory diseases affecting the middle ear (Dickson, 2014). OM in general is very common, as studies show that around 80 % of children should have experienced at least one episode by their third birthday (Teele et al., 1989). OM has been broadly classified into two main types, acute and chronic. Acute OM (AOM) is characterized by the rapid onset of signs of inflammation, specifically bulging and possible perforation of the tympanic membrane, fullness and erythema, as well as symptoms associated with inflammation such as otalgia, irritability and fever (Pukander, 1983;Harkness & Topham, 1998). Despite appropriate antibiotic therapy, AOM may progress to chronic suppurative OM (CSOM) characterized by persistent drainage from the middle ear associated with a perforated ear drum (Wintermeyer & Nahata, 1994;Harkness & Topham, 1998). When examined by otoscope, the middle ear looks red and inflamed with purulent discharge in CSOM patients (Figs 1 and 2). It is one of the most common chronic infectious diseases worldwide especially affecting children (Roland, 2002; Verhoeff et al., 2006). Hearing impairment is one of the most common sequelae of CSOM (Aarhus et al., 2015). The resultant hearing loss can have a negative impact on a child's speech development, education and behaviour (Olatoke et al., 2008; Khairi Md Daud et al., 2010). Mortality due to complications of CSOM is typically higher than other types of OM (Yorgancilar et al., 2013a;Qureishi et al., 2014). Intracranial complications like brain abscess and meningitis are the most common causes of death in CSOM patients (Dubey et al., 2010;Chew et al., 2012;Sun & Sun, 2014).In this article, the rec...

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“…The main predisposing factors are local trauma and exposure of the skin to water. Diagnosis is made using typical history and direct observations of the ear canal, which presents with diffusely swollen, extremely tender, and shiny skin . The treatment involves avoiding the causative agent and empirical use of topical antibiotics, with ciprofloxacin being the first choice.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that AOE is associated with bacterial proliferation in the ear canal . As the suction system continuously removes exudate, it is speculated that the NPWT may promote bacterial clearance and control its proliferation in the wound bed .…”

Section: Discussionmentioning

confidence: 99%

Acute otitis externa because of negative pressure wound therapy applied over the head and ear canal for scalping treatment

Castro

Coltro

Jorge

et al. 2018

International Wound Journal

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Scalping is considered a complex wound with difficult treatment, requiring early surgical intervention, reconstructive plastic surgery, and a multidisciplinary team. The reconstruction of the scalp frequently requires a combination of therapies, including temporary coverage, such as negative pressure wound therapy (NPWT). Complications of NPWT, such as bleeding, infection, and pain, have been described. However, there is no report of acute otitis externa (AOE) because of NPWT. In this article, we present an unprecedented clinical case – a female patient who developed AOE after scalping treatment with NPWT applied over the head and ear canal. We consider that it may be a result of the direct physical action of subatmospheric pressure, the presence of dressing covering the external meatus, and alteration of the bacterial population.

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Acute Otitis Media

Cited by 28 publications

References 31 publications

Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model

Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Acute otitis externa because of negative pressure wound therapy applied over the head and ear canal for scalping treatment

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