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Updated guidelines for the management of acute otitis media in children by the Italian Society of Pediatrics: diagnosis

Authors :
Elena Chiappini
Martina CiarciĆ 
Barbara Bortone
Mattia Doria
Paolo Becherucci
Gian Luigi Marseglia
Marco Antonio Motisi
Maurizio de Martino
Luisa Galli
Amelia Licari
Salvatore De Masi
Riccardo Lubrano
Maria Bettinelli
Claudio Vicini
Giovanni Felisati
Alberto Villani
Paola Marchisio
Publication Year :
2019
Publisher :
NLM (Medline), 2019.

Abstract

Background In recent years, new information has been acquired regarding the diagnosis, treatment and prevention of acute otitis media (AOM). The Italian Pediatric Society, therefore, decided to issue an update to the Italian Pediatric Society guidelines published in 2010. Methods The search was conducted on Pubmed, and only those studies regarding the pediatric age alone, in English or Italian, published between January 1, 2010 and December 31, 2018, were included. Each study included in the review was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology. The quality of the systematic reviews was evaluated using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 appraisal tool. The guidelines were formulated using the GRADE methodology by a multidisciplinary panel of experts. Results The importance of eliminating risk factors (passive smoking, environmental pollution, use of pacifier, obesity, limitation of day-care center attendance) and the promotion of breastfeeding and hygiene practices (nasal lavages) was confirmed. The importance of pneumococcal vaccination in the prevention of AOM was reiterated with regard to the prevention of both the first episode of AOM and recurrences. Grommets can be inserted in selected cases of recurrent AOM that did not respond to all other prevention strategies. Antibiotic prophylaxis is not recommended for the prevention of recurrent AOM, except in certain carefully selected cases. The use of complementary therapies, probiotics, xylitol and vitamin D is not recommended. Conclusions The prevention of episodes of AOM requires the elimination of risk factors and pneumococcal and influenza vaccination. The use of other products such as probiotics and vitamin D is not supported by adequate evidence.

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....a92c12456c1dc90a3438a8e8c86f653a