Artritis reumatoide

International Journal of Pediatric Otorhinolaryngology 74 (2010) 1209–1216

Contents lists available at ScienceDirect

International Journal of Pediatric Otorhinolaryngology

journal homepage: www.elsevier.com/locate/ijporl

Review article

Acute otitis media: From diagnosis to prevention. Summary of the Italian
guideline

Paola Marchisio a,1,*, Luisa Bellussi b,1, Giuseppe Di Mauroc,1, Mattia Doria d,1, Giovanni Felisati e,1,
Riccardo Longhi f,1, Andrea Novelli g,1, Annamaria Speciale h,1, Nicola Mansi i,1, Nicola Principi a,1

a

`
Department of Maternal and Pediatric Sciences, University of Milan and Foundation, IRCCS Ca Granda Ospedale Maggiore Policlinico, Italy
Italian Society of Pediatric Otolaryngology, Siena, Italy
Italian Society for Preventive and SocialPediatrics, Caserta, Italy
d
Primary Care Pediatrician, Venice, Italy
e
Department of Otolaryngology, University of Milan, Italy
f
Italian Society of Pediatrics, Como, Italy
g
Department of Pharmacology, University of Florence, Italy
h
Department of Microbiology, University of Catania, Italy
i
Italian Society of Pediatric Otolaryngology, Naples, Italy

b

c

A R T I C L E I N F OArticle history:
Received 6 July 2010
Received in revised form 17 August 2010
Accepted 18 August 2010
Available online 16 September 2010

Key words:
Acute otitis media
Otitis media
Antibiotic treatment
Watchful waiting
Vaccines
Prevention

A B S T R A C T

Acute otitis media (AOM) is the most common disease occurring in infants and children and has major
medical, social andeconomic effects. If we consider the Italian pediatric population and the incidence
rates in different age ranges it can be calculated that almost one million cases of AOM are diagnosed in
Italy every year. Various attempts have been made internationally to clarify the most appropriate ways
in which AOM should be managed. In Italy, this has been done at local or regional level but there have sofar been no national initiatives. The objective of this guideline is to provide recommendations to
pediatricians, general practitioners and otolaryngologists involved in the clinical management of acute
otitis media in healthy children aged 2 months to 12 years. After a systematic review and grading of
evidences from the literature, the document was drafted by a multidisciplinary panel withidentified key
clinical questions related to diagnosis, treatment of the acute episode, management of complications and
prevention.
ß 2010 Elsevier Ireland Ltd. All rights reserved.

Contents

1.

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1.
Reasons for an Italian guideline . . . . . . . . . . . . . . . . . . . . . . . . .. .
1.2.
Objective of the guideline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.3.
Development and implementation of the guideline . . . . . . . . . . .
Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.
Certain diagnosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.2.Diagnostic instruments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.3.
Ear wax removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1.
Earache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .
3.2.
Selection of patients to be immediately treated with antibiotics.
3.3.
Choice of antimicrobial drug . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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