小児急性中耳炎診断・治療Up to Date

抄録

The incidence of childhood acute otitis media has increased in children owing to changes in the social environment and development of resistant pathogenic bacteria, and therefore, number of cases resistant to treatment is also increasing. Therefore, it is critical to devise diagnostic techniques and new treatment modalities for this disease as well as for managing the adverse effects. In order to diagnose acute otitis media, quantitative (risk stratification) as well as qualitative diagnostic (pathogenic bacterium and drug sensitive) techniques have been accurately performed, following the treatment algorithm of the Childhood Acute Otitis Media Practice Guideline 2013. However, in case of patients resistant to the treatment, it is critical to develop a treatment modality based on the treatment algorithm. Along with increased administration of the antimicrobial agent, it is important to combine ear-nose-throat (ENT) surgical procedures, such as tympanostomy and eardrum ventilation tube placement procedure. In refractory, recurrent, and prolonged otitis media case, short-term eardrum ventilation tube placement surgery is effective, and early treatment without hesitation is preferable, while taking into account the condition of children with otitis media. Further, in order to prevent antibiotic resistant pathogenic bacteria, appropriate use of antibacterial drugs is critical. Unregulated increased usage of new antimicrobial agents should be discouraged.