OTITIS MEDIA AGUDA. DIAGNÓSTICO Y MANEJO PRÁCTICO

Acute otitis media is a very frequent cause of medical visit and antimicrobial use in children. Clinical diagnosis should be performed with pneumatic otoscopy. Management of AOM requires a thorough clinical exam and updated knowledge of local patterns of microorganisms involved and antimicrobial susceptibility profiles, knowing that the presence of these microorganisms in AOM transtimpanic exudate cultures may vary depending on geographical areas and vaccination. AOM can be treated either with inmediate antibiotic or with observation depending on patients and clinical characteristics. The most common microorganism causing AOM are Pneumococcus, Haemophilus Influenzae, and Moraxella catarrhalis. S. pneumoniae has acquired resistance to penicillin in the last decade that cannot be extrapolated to Amoxicillin. Based on this data Amoxicillin is recommended as the first choice. For amoxicillin failure, cefalosporins or B lactamase can be prescribed. Patients that presents with recurrent AOM should be refered to otolaryngologist for further evaluation and treatment.