Otitis media is a medical condition that is literally translated from Latin to mean “inflammation of the middle ear”. The infection occurs in the area between the eardrum and the outer ear and can be very painful.

Epidemiology

It is a common condition and approximately 11% of the worldwide population experiences at least one episode of acute otitis media each year. Half of all cases occur in children less than five years old, and it is more common for males to be affected.

A possible complication of the condition is chronic suppurative otitis media. It is estimated that nearly 1 in 20 people affected by an acute episode will develop the chronic condition, which can last for weeks to months.

The vast majority (80%) of children will experience otitis media with effusion at some point in time before the age of ten years. It is the most common condition that needs medical care in the US for children less than five.

In 2013 otitis media resulted in 2,400 deaths, which a big improvement from 1990 when 4,900 deaths occurred.

Risk Factors

There are some factors that have been linked to a higher risk of otitis media. This includes children that are exposed to polluted environments, particularly if the parents smoke at home. Additionally, using a pacifier rather than breastfeeding and attending daycare from an earlier age with many attendees can have a bad effect.

Therefore, to help decrease the risk of otitis media, it is suggested parents should endeavor to limit smoking in the home environment. Mothers should also be encouraged to breastfeed for as long as possible and, if daycare is required, centers with as few attendees as possible should be chosen.

Symptoms

Ear pain is the characteristic symptom of otitis media, which is sometimes also described as a feeling of fullness in the ear. This may also cause people to be irritable, as well as fatigued and have a decreased appetite.

When the condition is particularly severe and often after inadequate treatment, it is possible for the tympanic membrane to rupture. Whilst this is often accompanied by a feeling of relief as the pressure inside the ear is released, this can lead to excessive draining of the ear and increases susceptibility to severe infection inside the ear.

Additionally, it is possible for hearing loss to occur, which may be temporary or permanent, depending on the circumstances of the event.

Treatment

The majority of cases of acute otitis media tend to resolve on their own within a few days. For this reason, a simple analgesic for pain relief is often sufficient treatment for many cases of acute otitis media. This helps to reduce pain and irritability of children whilst the infection passes of its own accord.

However, for people with particularly severe pain and fever symptoms or for those less than 24 months old treatment with antibiotics should be initiated.

Amoxicillin is the treatment of choice for most patients, however amoxicillin-clavulanate is a suitable alternative if there is suspected resistance to amoxicillin or if it has already been used in the previous 30 days.

An improvement of symptoms should be evident within 2 to 3 days. If the condition does not seem to be improving, it is recommended to add or change treatment regime as the current therapy is unlikely to be offering a large benefit.