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Updated guidelines for the management of acute otitis media in children by the Italian Society of Pediatrics: diagnosis
- 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.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
pediatrics
diagnosis
MEDLINE
Breastfeeding
Environmental pollution
preschool
NO
03 medical and health sciences
0302 clinical medicine
otoscopy
030225 pediatrics
otorhinolaryngologic diseases
medicine
guidelines
030212 general & internal medicine
Antibiotic prophylaxis
Intensive care medicine
humans
acute disease
diagnosis, acute otitis media, guidelines, otoscopy
First episode
child
business.industry
acute otitis media
otitis media
Guideline
Settore MED/38
infant
acoustic impedance tests
Infectious Diseases
Otitis
Systematic review
Italy
Child, Preschool
adolescent
Pediatrics, Perinatology and Child Health
child, preschool
medicine.symptom
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....a92c12456c1dc90a3438a8e8c86f653a