Acute otitis media (AOM) is among the most common pediatric diagnoses in the emergency department and occurs in approximately 80% of children. AOM most typically manifests as otalgia with ear tugging with a constellation of other nonspecific symptoms such as irritation, vomiting, or diarrhea. Diagnosis of AOM is performed via otoscopic findings in the correct clinical context with correlating patient history. Recurrent AOM is defined as three episodes of AOM within six months or four episodes within a year, and treatment guidelines are sparse and lacking. Pharmacologic interventions emphasized properly culturing the microbe to ensure adequate antibiotic coverage and mitigate formation of antibiotic resistance, while vaccinations with a pneumococcal conjugate vaccine did not lead to any meaningful reduction in rates of recurrent AOM. Surgical interventions investigated include tympanostomy tubes, Eustachian tube balloon dilation, and adenoidectomy, which all yielded statistically insignificant differences when compared to their controls. Currently, a tailored approach in treating children with recurrent AOM should be undertaken that balances the severity of illness with the consequences of antibiotics or surgery.
Monayao, Marlon C., "Pharmacologic vs. Surgical Intervention in Recurrent Acute Otitis Media in Children; A Literature Review" (2023). MEDI 8127 Scholarly Activities Pre-Clerkship. 52.