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==Overview==
==Overview==
Specific prevention strategies applicable to all infants and children such as [[immunization]] against viral respiratory infections or specifically against the [[bacteria]] that cause otitis media are not currently available. Nevertheless, it is known that children who are cared for in group settings, as well as children who live with adults who smoke cigarettes, have more ear infections. Therefore, a child who is prone to otitis media should avoid contact with sick playmates and environmental tobacco smoke. Infants who nurse from a bottle while lying down also appear to develop otitis media more frequently. Children who have been breast-fed often have fewer episodes of otitis media. Research has shown that cold and allergy medications such as [[antihistamine]]s and [[decongestant]]s are not helpful in preventing ear infections. The best hope for avoiding ear infections is the development of [[vaccine]]s against the bacteria that most often cause otitis media. Scientists are currently developing vaccines that show promise in preventing otitis media. Additional clinical research must be completed to ensure their effectiveness and safety.
Preventing otitis media primarily involves preventing developing [[nasopharyngitis]]. This is achieved by the ''[[pneumococcal]]'' and [[influenza]] [[vaccines]], frequently washing hands, and avoiding fluid transmission and respiratory droplets from [[nasopharyngitis]] patients. Preventing exposure to air pollution as potential [[middle ear]] irritants, such as secondhand smoke, contributes to preventing otitis media. For infants, preventative measures include avoiding pacifiers, avoiding daycare enrollment, and [[breastfeeding]] until at least 6 months of age. A [[prophylactic]] regimen of [[antibiotics]] can prevent otitis media in at-risk infants and children. For otitis media that is chronic or recurrent, preventing recurrence of the disease involves surgery, assuming the manifestation is not self-limited. [[Myringotomy]] with [[tympanostomy tube]] is the most common surgical preventative measure.


==Primary Prevention==
==Primary Prevention==
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**Avoiding [[coughing]] and [[respiratory]] droplets from [[respiratory illness]] indicative [[nasopharyngitis]].
**Avoiding [[coughing]] and [[respiratory]] droplets from [[respiratory illness]] indicative [[nasopharyngitis]].
*Avoiding first or secondhand smoke or other air pollutants with potential for [[middle ear]] irritation.<ref name="urlEar infection - acute: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000638.htm |title=Ear infection - acute: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
*Avoiding first or secondhand smoke or other air pollutants with potential for [[middle ear]] irritation.<ref name="urlEar infection - acute: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000638.htm |title=Ear infection - acute: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
*Avoiding use of pacifiers in infants
*Avoiding use of pacifiers in infants.
*Avoiding enrollment in daycares
*Avoiding enrollment in daycares.
*[[Breastfeeding]] infants until at least 6 months of age.<ref name="pmid19581824">{{cite journal |vauthors=Sabirov A, Casey JR, Murphy TF, Pichichero ME |title=Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6 |journal=Pediatr. Res. |volume=66 |issue=5 |pages=565–70 |year=2009 |pmid=19581824 |pmc=2783794 |doi=10.1203/PDR.0b013e3181b4f8a6 |url=}}</ref>
*[[Breastfeeding]] infants until at least 6 months of age.<ref name="pmid19581824">{{cite journal |vauthors=Sabirov A, Casey JR, Murphy TF, Pichichero ME |title=Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6 |journal=Pediatr. Res. |volume=66 |issue=5 |pages=565–70 |year=2009 |pmid=19581824 |pmc=2783794 |doi=10.1203/PDR.0b013e3181b4f8a6 |url=}}</ref>
**This is correlated with higher levels of [[antibodies]] to acute otitis media cause nontypeable ''[[Haemophilus influenzae]]'', as well as pathogenic outer membrane [[protein]] [[P6]].
**This is correlated with higher levels of [[antibodies]] to acute otitis media cause nontypeable ''[[Haemophilus influenzae]]'', as well as pathogenic outer membrane [[protein]] P6.
*Administering a [[prophylactic]] antibiotic regimen for children at risk for developing otitis media:
*Administering a [[prophylactic]] antibiotic regimen for children at risk for developing otitis media:
**Preferred regimen (1): [[Amoxicillin]] 20 mg/kg po once daily<ref name="pmid17054203">{{cite journal| author=Leach AJ, Morris PS| title=Antibiotics for the prevention of acute and chronic suppurative otitis media in children. | journal=Cochrane Database Syst Rev | year= 2006 | volume=  | issue= 4 | pages= CD004401 | pmid=17054203 | doi=10.1002/14651858.CD004401.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17054203  }} </ref>
**Preferred regimen (1): [[Amoxicillin]] 20 mg/kg po once daily.<ref name="pmid17054203">{{cite journal| author=Leach AJ, Morris PS| title=Antibiotics for the prevention of acute and chronic suppurative otitis media in children. | journal=Cochrane Database Syst Rev | year= 2006 | volume=  | issue= 4 | pages= CD004401 | pmid=17054203 | doi=10.1002/14651858.CD004401.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17054203  }} </ref>
**Preferred regimen (2): [[Sulfisoxazole]] 50 mg/kg po at bedtime<ref name="pmid17054203">{{cite journal| author=Leach AJ, Morris PS| title=Antibiotics for the prevention of acute and chronic suppurative otitis media in children. | journal=Cochrane Database Syst Rev | year= 2006 | volume=  | issue= 4 | pages= CD004401 | pmid=17054203 | doi=10.1002/14651858.CD004401.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17054203  }} </ref>
**Preferred regimen (2): [[Sulfisoxazole]] 50 mg/kg po at bedtime.<ref name="pmid17054203">{{cite journal| author=Leach AJ, Morris PS| title=Antibiotics for the prevention of acute and chronic suppurative otitis media in children. | journal=Cochrane Database Syst Rev | year= 2006 | volume=  | issue= 4 | pages= CD004401 | pmid=17054203 | doi=10.1002/14651858.CD004401.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17054203  }} </ref>
**Alternative Regimen (1): [[TMP-SMX]] 4 mg-20 mg/kg once daily<ref name="pmid17054203">{{cite journal| author=Leach AJ, Morris PS| title=Antibiotics for the prevention of acute and chronic suppurative otitis media in children. | journal=Cochrane Database Syst Rev | year= 2006 | volume=  | issue= 4 | pages= CD004401 | pmid=17054203 | doi=10.1002/14651858.CD004401.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17054203  }} </ref>
**Alternative Regimen (1): [[TMP-SMX]] 4 mg-20 mg/kg once daily.<ref name="pmid17054203">{{cite journal| author=Leach AJ, Morris PS| title=Antibiotics for the prevention of acute and chronic suppurative otitis media in children. | journal=Cochrane Database Syst Rev | year= 2006 | volume=  | issue= 4 | pages= CD004401 | pmid=17054203 | doi=10.1002/14651858.CD004401.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17054203  }} </ref>


==Secondary Prevention==
==Secondary Prevention==
*For chronic, recurrent cases of otitis media with [[suppuration]] or [[effusion]], the most common preventative measure is [[surgery]].<ref name="pmid24453496">{{cite journal |vauthors=Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M |title=Update on otitis media - prevention and treatment |journal=Infect Drug Resist |volume=7 |issue= |pages=15–24 |year=2014 |pmid=24453496 |pmc=3894142 |doi=10.2147/IDR.S39637 |url=}}</ref>
*For chronic, recurrent cases of otitis media with [[suppuration]] or [[effusion]], the most common preventative measure is [[surgery]].<ref name="pmid24453496">{{cite journal |vauthors=Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M |title=Update on otitis media - prevention and treatment |journal=Infect Drug Resist |volume=7 |issue= |pages=15–24 |year=2014 |pmid=24453496 |pmc=3894142 |doi=10.2147/IDR.S39637 |url=}}</ref>
**[[Myringotomy]] with [[tympanostomy]] tube is used to prevent recurrence of otitis media due to build up of [[suppurative]] discharge or effusive fluid buildup.<ref name="pmid6540871">{{cite journal |vauthors=Bluestone CD |title=Surgical management of otitis media |journal=Pediatr Infect Dis |volume=3 |issue=4 |pages=392–6 |year=1984 |pmid=6540871 |doi= |url=}}</ref>
**[[Myringotomy]] with [[tympanostomy tube]] is used to prevent recurrence of otitis media due to build up of [[suppurative]] discharge or effusive fluid buildup.<ref name="pmid6540871">{{cite journal |vauthors=Bluestone CD |title=Surgical management of otitis media |journal=Pediatr Infect Dis |volume=3 |issue=4 |pages=392–6 |year=1984 |pmid=6540871 |doi= |url=}}</ref>
   
   
==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Primary care]]
{{WH}}
{{WS}}
 
[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Otolaryngology]]
[[Category:Otolaryngology]]
[[Category:Otology]]
[[Category:Otology]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
{{WH}}
{{WS}}

Latest revision as of 23:30, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hardik Patel, M.D.; Faizan Sheraz, M.D. [2]; Luke Rusowicz-Orazem, B.S.

Overview

Preventing otitis media primarily involves preventing developing nasopharyngitis. This is achieved by the pneumococcal and influenza vaccines, frequently washing hands, and avoiding fluid transmission and respiratory droplets from nasopharyngitis patients. Preventing exposure to air pollution as potential middle ear irritants, such as secondhand smoke, contributes to preventing otitis media. For infants, preventative measures include avoiding pacifiers, avoiding daycare enrollment, and breastfeeding until at least 6 months of age. A prophylactic regimen of antibiotics can prevent otitis media in at-risk infants and children. For otitis media that is chronic or recurrent, preventing recurrence of the disease involves surgery, assuming the manifestation is not self-limited. Myringotomy with tympanostomy tube is the most common surgical preventative measure.

Primary Prevention

Secondary Prevention

References

  1. ↑ Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, Joffe MD, Miller DT, Rosenfeld RM, Sevilla XD, Schwartz RH, Thomas PA, Tunkel DE (2013). "The diagnosis and management of acute otitis media". Pediatrics. 131 (3): e964–99. doi:10.1542/peds.2012-3488. PMID 23439909.
  2. ↑ "Ear infection - acute: MedlinePlus Medical Encyclopedia".
  3. ↑ Sabirov A, Casey JR, Murphy TF, Pichichero ME (2009). "Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6". Pediatr. Res. 66 (5): 565–70. doi:10.1203/PDR.0b013e3181b4f8a6. PMC 2783794. PMID 19581824.
  4. ↑ 4.0 4.1 4.2 Leach AJ, Morris PS (2006). "Antibiotics for the prevention of acute and chronic suppurative otitis media in children". Cochrane Database Syst Rev (4): CD004401. doi:10.1002/14651858.CD004401.pub2. PMID 17054203.
  5. ↑ Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M (2014). "Update on otitis media - prevention and treatment". Infect Drug Resist. 7: 15–24. doi:10.2147/IDR.S39637. PMC 3894142. PMID 24453496.
  6. ↑ Bluestone CD (1984). "Surgical management of otitis media". Pediatr Infect Dis. 3 (4): 392–6. PMID 6540871.

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