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Book and Media Reviews
November 21, 2007

Otitis Media in Infants and Children

JAMA. 2007;298(19):2313-2318. doi:10.1001/jama.298.19.2316

In the year 2000, 16 million visits were made to office-based physicians in the United States for otitis media. In fact, otitis media is the most common reason for visits to pediatricians by ill children and is the most common infection for which antibacterial agents are prescribed for children in the United States. Although an apparent increase in this diagnosis occurred during the final quarter of the 20th century, otitis media is not a new disease. For example, among the other historical gems scattered throughout this text, readers discover that tympanic membrane perforations were found in 2600-year-old Egyptian mummies, that 27% of all pediatric admissions to Bellevue Hospital in 1932 were for the treatment of purulent otitis media, and that acute mastoiditis was the most common infection for which infants and children were hospitalized in this country during the preantibiotic era. Times have changed; hospitalization for otitis and its complications has become rare. The predominant pathogens have metamorphosed, from the group A streptococcus and Staphylococcus aureus prevalent before the introduction of antibiotics, to the currently prevalent pneumococcus and Haemophilus influenzae. Clinicians are undoubtedly again witnessing a shift in the prevailing etiologic agents and perhaps a decrease in the incidence of the disease because of newer vaccines (eg, pneumococcal conjugate vaccine) and more circumspect diagnosis.

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