Otitis Media Aguda

Jhonattan Cabrales Lara Médico Interno Universidad de Cartagena

[object Object],[object Object],[object Object],[object Object],Diagnosis and Management of Acute Otitis Media; PEDIATRICS Vol. 113 No. 5 May 2004

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Rosenfeld Bluestone. Evidence Based Otitis Media. Secon Edition 2006

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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Diagnosis and Management of Acute Otitis Media; PEDIATRICS Vol. 113 No. 5 May 2004

[object Object],Llenado o Abombamiento 89% Opacidad 52% Enrojecimiento 46% Color amarillo 24%

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Fase Trasudado Fase Exudado Fase Supurativa Fase Hiperémica

TRATAMIENTO ANTIBIOTICO ? Cuándo? A qué Pacientes? Con qué?

S. Neumoniae 32% H. Influenza Virus 25% 20% M. Catarralis 15% S. Grupo A-B 5% Staf. Aureus 2% P. Auriginosa 1% 50% de resistencia intermedia a la panicilina 30% productor de B-lactamasa 100% productor B-lactamasa

% of Isolates Resistant to Penicillin Year Breiman RF, et al. JAMA . 1994;271:1831-1835. Doern GV, et al. AAC . 1996;40:1208-1213. Thornsberry C, et al. DMID. 1997;29:249-257 . Thornsberry C, et al. JAC. 1999;44:749-759. Thornsberry C, et al. CID 2002;34(S1):S4-S16. Karlowsky, et al. CID. 2003;36:963-970. Sahm, et al. IDSA 2003 , abstract 201. Data on file, Ortho-McNeil Pharmaceutical, Inc. In vitro activity does not necessarily correlate with clinical results.

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Recomendaciones: OMA AAP. Pediatrics, mayo 2004

[object Object],[object Object],[object Object],[object Object],[object Object],Recomendaciones: OMA AAP. Pediatrics, mayo 2004

[object Object],[object Object],[object Object],Recomendaciones: OMA AAP. Pediatrics, mayo 2004

[object Object],[object Object],[object Object],[object Object],Recomendaciones: OMA AAP. Pediatrics, mayo 2004; Cefuroxime (Zinat); cefprozil (procef)

Dagan R. Pediatr Infect Dis J, 2000;19:S57-65 Paciente con Falla Bacteriológica (%) Pen-Susceptible Pen-No Susceptible Placebo

Paciente con Falla Bacteriológica (%) Betalactámicos Dagan R. Pediatr Infect Dis J, 2000;19:S57-65 Pen-Susceptible Pen-No Susceptible Placebo

Calificación Antibiótico The Canadian Journal of CME. July 1997

[object Object],[object Object],[object Object],[object Object],Recomendaciones: OMA AAP. Pediatrics, mayo 2004; Acuin J, Mackenzie I. Treatment of chronic suppurative otitis media. The Cochrane Library. Issue 2, 1999.

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