@article{1426cef6f70b40998211b04788c28667,
title = "Otitis media and its consequences: beyond the earache",
abstract = "An international group of multidisciplinary experts on middle-ear and paediatric infections met to explore where consensus exists on the management of acute otitis media. After informal discussions among several specialists of paediatric infectious disease, the group was expanded to include a larger spectrum of professionals with complementary expertise in middle-ear disease. Acute otitis media is a very common bacterial infection in children worldwide, leading to excessive antibiotic consumption in children in most countries and to a substantial burden of deafness and suppurative complications in developing countries. The group attempted to move beyond the existing controversies surrounding guidelines on acute otitis media, and to propose to clinicians and public health officials their views on the actions needed to be taken to reduce the disease burden caused by acute otitis media and the microbial antibiotic resistance from the resulting use of antibiotics. Definition of acute otitis media and diagnostic accuracy are crucial steps to identify children who will potentially benefit from treatment with antibiotics and to eliminate unnecessary prescribing. Although the group agreed that antibiotics are distributed indiscriminately, even to children who do not seem to have the disease, no consensus could be reached on whether antibiotics should be given to all appropriately diagnosed children, reflecting the wide range of practices and lack of convincing evidence from observational studies. The major unanimous concern was an urgent need to reduce unnecessary prescribing of antibiotics to prevent further increases in antibiotic resistance. Prevention of acute otitis media with existing and future viral and bacterial vaccines seems the most promising approach to affect disease burden and consequences, both in developed and developing countries.",
author = "Anne Vergison and Ron Dagan and Adriano Arguedas and Jan Bonhoeffer and Robert Cohen and Ingeborg DHooge and Alejandro Hoberman and Johannes Liese and Paola Marchisio and Palmu, {Arto A.} and Ray, {G. Thomas} and Sanders, {Elisabeth AM} and Sim{\~o}es, {Eric AF} and Matti Uhari and {van Eldere}, Johan and Pelton, {Stephen I.}",
note = "Funding Information: This paper originated from several days of presentations, evaluations, and discussions regarding otitis media. Funding for these meetings was provided by an unrestricted educational grant from GSK through LMS-Group, a medical education company. Neither GSK nor LMS-Group had a role in determining the content of this paper. Catherine Kidd (Caudex Medical Ltd, Oxford, UK), supported by GSK, collated author disclosures. Funding Information: Crucial topics regarding acute otitis media, such as disease definition and diagnosis, indications for the prescription of antibiotics, acceptance of treatment guidelines, and effectiveness of preventive interventions remain unresolved. Scientific societies, specialists in otitis media, and evidence-based medicine experts have proposed many recommendations for the management of the disease. However, no real consensus practices exist and there is evidence that worldwide most physicians systematically prescribe antimicrobial drugs for the treatment of children with otitis media. 1 In March, 2008, international experts on infectious diseases in children participated in a masterclass on bacterial infections of the respiratory tract. After the debates held during that meeting over the numerous unresolved issues on acute otitis media, we proposed to broaden and rationalise the discussion with an extended group including specialists in epidemiology, otorhinolaryngology, diagnosis and management of acute otitis media, microbiology, pharmacoeconomics, prevention, and global health. Three more formal meetings took place between September, 2008, and January, 2009. The meetings were funded by an unrestricted educational grant from GlaxoSmithKline through LMS-Group, a medical education company. In this paper, our international multidisciplinary group focus on the consensus that was reached for the practical management of acute otitis media in the context of increasing antimicrobial resistance among bacterial pathogens and the perspective of evolving interventions for reducing the burden of disease. Our intention is that this analysis will help decision making by clinicians and raise the awareness of public health authorities to the need to develop approaches for reducing direct and indirect consequences of acute otitis media. ",
year = "2010",
month = jan,
day = "1",
doi = "10.1016/S1473-3099(10)70012-8",
language = "English",
volume = "10",
pages = "195--203",
journal = "The Lancet Infectious Diseases",
issn = "1473-3099",
publisher = "Lancet Publishing Group",
number = "3",
}