About AOM

Acute otitis media, also known as a middle ear infection is the number one reason children are taken to the physician’s office outside of “well-baby” visits every year.

 Acute otitis media is one of the most common infections treated by physicians and represents the number one reason antibiotics are prescribed to children in the United States.

AOM is often associated with pain and temporary hearing loss, while children between the ages of 6 months and 24 months of age are most commonly affected.

How AOM Occurs

Middle ear infections often begin or are preceded by an infection in the upper respiratory tract. Research has shown that pathogens contained within the upper respiratory tract migrate through the Eustachian tube to the middle ear causing an infection. The secretion of fluid and inflammation generated by this infection causes the Eustachian tube to become inflamed and blocked, allowing bacteria to proliferate within the middle ear. This proliferation causes fluid within the middle ear to build, increasing pressure on the tympanic membrane (ear drum), resulting in varying degrees of pain and hearing loss. The three most common bacteria causing AOM are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, collectively accounting for 86% of bacterial cases of AOM.

Recent studies point to the fact that in a majority of children, AOM is a co-infection of both bacteria and viruses. More specifically it was demonstrated that bacteria were implicated in 92% of AOM cases while viruses were implicated in 70% of cases, demonstrating a 66% incidence of co-infection (infections caused by both viruses and bacteria).

Diagnosis and Treatment of AOM

Accurately identifying and diagnosing acute otitis media, according to the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), involves firmly establishing the presence of three primary elements:

• Acute onset
• Presence of middle ear effusion (fluid)
• Signs of middle ear inflammation

Once a diagnosis of acute otitis media has been confirmed there is a specific guideline recommending a defined course of treatment with an antibiotic for many patients. According to the US Centers for Disease Control and Prevention (CDC), approximately 99% of children diagnosed with otitis media receive antibiotics for acute episodes. However, concerns surrounding antibiotic-resistant bacteria and subsequent antimicrobial failures have caused many to question the routine use of antibiotics in children with AOM. Recently the AAP, CDC and World Health Organization have supported an approach whereby clinicians and patients more prudently prescribe and use antibiotics for less complicated infections. This approach supports having patients wait to fill their antibiotic prescriptions while treating the symptoms in hopes that the infection will subside. If the infection does not subside, then it is recommended the antibiotic prescription be filled and administered.

Otic analgesics (ear drops applied directly to the ear) are often prescribed by physicians to directly address the pain and inflammation accompanying ear infections. Several treatment options exist to treat these symptoms, and NEOTIC is the newest available treatment option.

Various factors, both environment and host related, contribute to common middle ear infections. Some examples of these risk factors include the frequency and duration of group childcare exposure, exposure to passive smoke, and a family history of AOM.