Prevention of acute mastoiditis: fact or fiction?

Linder, Thomas; Briner, Hans Rudolf; Bischoff, Thomas

doi:10.1016/s0165-5876(00)00410-9

Cited by 42 publications

(38 citation statements)

References 10 publications

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“…None of the cultures showed any resistance to penicillin, a result that echoes the findings of other studies. 4,12 This, along with our stable rate of AM cases, stands in contrast to recent findings of Antonelli et al, 13 which demonstrated that antibioticresistant S pneumoniae may be responsible for an increasing rate of AM.…”

Section: Commentcontrasting

confidence: 83%

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The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

Rotenberg

Berkowitz³

2008

Arch Otolaryngol Head Neck Surg

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Section: Commentcontrasting

confidence: 83%

“…[5][6][7][8][9][10][11][12]. Each year, different numbers of cases were identified without evidence of a trend toward either increased or decreased incidence (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

Rotenberg

Berkowitz³

2008

Arch Otolaryngol Head Neck Surg

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“…S. pneumoniae and S. pyogenes are the two most virulent pathogens of the middle ear, and they are the leading causes of complications such as mastoiditis, labyrinthitis, and meningitis (15,22,23,28,38).…”

mentioning

confidence: 99%

The Binax NOW Test as a Tool for Diagnosis of Severe Acute Otitis Media and Associated Complications

Gisselsson-Solén

Bylander²,

Wilhelmsson

et al. 2007

J Clin Microbiol

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The diagnosis of acute otitis media (AOM) is often difficult, depending heavily on the experience and skills of the examiner. However, it is important to identify episodes of AOM that involve the risk of complications and to treat these episodes appropriately. The present study was performed in order to evaluate the use of a rapid antigen assay for Streptococcus pneumoniae, the Binax NOW test, as a diagnostic tool in patients with severe AOM and associated complications. The study included 70 patients with 74 episodes of AOM, 18 of them with complications. Cultures, Binax NOW tests, and a PCR assay were performed on nasopharyngeal secretions, middle ear fluid, and in some cases mastoid bone, cerebrospinal fluid, and urine. According to culture and PCR of the middle ear fluid, 30 (41%) of the episodes were caused by S. pneumoniae. The Binax NOW test was positive in 24 of these episodes (80%). It identified pneumococcal AOM independent of antibiotic treatment, and it was easily adapted to bone tissue. The test yielded sensitivity, specificity, and positive and negative predictive values for middle ear specimens of 85%, 100%, 100%, and 89%, respectively. The corresponding positive and negative values for predicting the bacterial etiology with nasopharyngeal secretions were 51% and 75%. This study showed that the Binax NOW test is a useful diagnostic tool for patients with severe AOM with or without complications.Acute purulent otitis media (AOM) is the most common bacterial infection diagnosed among children. By 3 years of age, up to 85% of all children have experienced at least one episode of AOM (40), and 15 to 20% of the children suffer from recurrent episodes (1, 7).The most frequent microbiological cause of AOM is Streptococcus pneumoniae (26 to 48%), followed by Haemophilus influenzae (15 to 41%), Moraxella catarrhalis (23 to 25%), and Streptococcus pyogenes (4 to 8%) (2,3,20,27). S. pneumoniae and S. pyogenes are the two most virulent pathogens of the middle ear, and they are the leading causes of complications such as mastoiditis, labyrinthitis, and meningitis (15,22,23,28,38).AOM is the single most common reason for prescribing antibiotics to children (12, 24). The antibiotic load and selective pressure in the youngest age groups are consequently high, and clinical problems with antibiotic resistance have emerged (5, 41). The routine use of antimicrobial drugs in AOM treatment has been reevaluated in recent years, and watchful waiting has become an alternative (34). Watchful waiting is, however, not without risk. A safer approach is to use stricter diagnostic criteria for AOM, to improve the diagnostic tools, and to treat only those patients who are the least likely to recover spontaneously.The diagnosis of AOM, especially in young children, is often difficult and inadequate (4,12,33,42). Previous studies have shown that physicians are uncertain of the diagnosis in 40% of cases (31), and general practitioners are more likely to diagnose AOM than are otorhinolaryngologists (4). Furthermore, about 49 to 88% ...

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“…In the present study, patients were given antibiotics prior to hospital care in 39% of the acute mastoiditis patients. About the same rate of pre-hospital use of antibiotics were found in other studies [6,10], but a higher rate of antibiotic use prior to the mastoiditis episode was more commonly found [3,5,9,[11][12][13]. There is disagreement on whether routine antibiotic use in AOM protects against mastoiditis [6] or is no safeguard against the development of mastoiditis [5,11].…”

Section: Discussionmentioning

confidence: 76%

“…The treatment of choice for acute mastoiditis has traditionally been a combination of antibiotics and surgical intervention (myringotomy and in severe cases mastoidectomy) [12], but in some centers surgery is used much more sparingly [15]. In a retrospective study from Spain [7] of children with acute mastoiditis ranging over the same time span as in the present study (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005), the number of patients who underwent mastoidectomy increased.…”

Section: Discussionmentioning

confidence: 99%

Acute mastoiditis in southern Sweden: a study of occurrence and clinical course of acute mastoiditis before and after introduction of new treatment recommendations for AOM

Stenfeldt

Hermansson

2010

Eur Arch Otorhinolaryngol

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Watchful waiting was recommended as an option for uncomplicated episodes of acute otitis media in Sweden in the year 2000. Concern was raised that these recommendations would lead to a higher incidence of acute mastoiditis. The aim of this study was to map the occurrence, treatment policy and the clinical course of mastoiditis before and after the new treatment recommendations were introduced. Included in the study were all patients (adults and children) who were admitted to two ENT departments in southern Sweden for acute mastoiditis from 1996 to 2005. A total of 42 cases of mastoiditis were identified: 23 during the first period of 1996-2000 and 19 during 2001-2005. Mastoidectomy was performed in 14 patients during the first period and in 8 during the second period. As much as 39% of mastoiditis patients received antibiotics before hospital care, but had no improvement. There was no indication that the number of patients with acute mastoiditis was increasing after new treatment recommendation of AOM. There was no increase in the occurrence of mastoidectomy. Severe complications of mastoiditis were rare. Although there were potentially threatening complications of mastoiditis in the study, these did not lead to sequelae. It is important to follow up the consequences when treatment recommendations of AOM are changed.

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Prevention of acute mastoiditis: fact or fiction?

Cited by 42 publications

References 10 publications

The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

The Binax NOW Test as a Tool for Diagnosis of Severe Acute Otitis Media and Associated Complications

Acute mastoiditis in southern Sweden: a study of occurrence and clinical course of acute mastoiditis before and after introduction of new treatment recommendations for AOM

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