Clinical Practice Guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan – 2013 update

Acute otitis media guidelines in selected developed and developing countries: uniformity and diversity

“…Two reviewers independently chose to compare AOM guidelines from Italy ( Europe ),11 the USA ( Americas ),12 Japan ( Asia ),13 14 South Australia ( Oceania ),15 and South Africa ( Africa ) 16. We were forced to make these exceptions: (1) for Oceania , guidelines from the state of South Australia were chosen, which were the most appropriate detailed publication from this region, but cannot be considered as a national guideline; (2) for Europe , several countries met the inclusion criteria, such as Italy, the UK, Spain and the Netherlands.…”

Impact of the Seven-valent Pneumococcal Conjugate Vaccine on Acute Otitis Media in Japanese Children

“…According to Japanese clinical practice guidelines and the American Academy of Pediatrics guideline, penicillins are recommended as a first-line treatment for AOM. 13,19 However, we found that all strains of serotype 15A isolated from Japanese children with AOM were nonsusceptible to PCG. In fact, all serotype 15A strains were nonsusceptible to at least 3 drug classes and were classified as multidrug-resistant S. pneumoniae.…”

“…Because overuse of TBPM and TFLX may reduce susceptibility to carbapenems and fluoroquinolones, these drugs are not recommended for first-line treatment in clinical practice guidelines on the diagnosis and management of pediatric AOM in Japan, and we have to pay attention to appropriate prescription of these agents. 13 In patients with IPD, replacement of other serotypes by serotype 19A is becoming a major problem since the introduction of PCV7. 3,7 In the case of AOM, similar serotype replacement by serotype 19A has been reported.…”

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups

“…One of the possible explanations is an immunologically compromised state because of poor nutritional intake and differences in therapeutic strategies that led to protracted inflammation of the middle ear. Previously, only local treatment such as tympanostomy was utilized as the primary treatment modality in Japan because of the absence of effective antibiotics, but the administration of antibiotics is now a standard treatment for severe acute otitis media in children [9,10] . Because elderly patients over the age of 65 suffered from otitis media before antibiotics became a popular treatment, acute otitis media might have been hard to control and led to mastoiditis in those days, and recurrent acute otitis media might have inhibited the growth of their mastoid air cells in childhood.…”