ACUTE OTITIS MEDIA: DIAGNOSIS, TREATMENT, AND CLINICAL CONSIDERATIONS

Abstract

Acute otitis media (AOM) is a common condition in pediatrics, affecting up to 80% of children by the age of 3. This public health issue incurs considerable costs for healthcare systems due to consultations, treatments, and, in some cases, surgeries. AOM is often preceded by upper respiratory tract infections that cause inflammation in the Eustachian tube, leading to fluid accumulation in the middle ear. Factors such as age, family history, and exposure to cigarette smoke increase the risk. The pathogens causing AOM have changed over time, especially after the introduction of the pneumococcal vaccine, which reduced pneumococcal infections but allowed the emergence of other agents, such as Streptococcus pyogenes. Diagnosis is clinical, with otoscopy being essential to confirm the presence of fluid and inflammation in the middle ear. Many cases are self-limiting, with an emphasis on pain management and observation. The analysis included peer-reviewed studies and followed PRISMA guidelines, focusing on diagnosis, treatment, and pathological mechanisms. The COVID-19 pandemic brought new challenges, revealing complex interactions between viral infections and AOM that require adaptation of treatment strategies. Treatment varies according to the severity and age of the child, with amoxicillin as the first-line treatment, although bacterial resistance necessitates alternatives. Pain management is crucial, and the insertion of ventilation tubes may be considered in recurrent cases. Future research should focus on the interactions between infections and the impact of interventions to optimize the care of children. AOM is a complex condition that requires an integrated and evidence-based approach, aiming not only for effective treatment but also for prevention and reduction of recurrences, ensuring better auditory health and quality of life for children.