Antibiotics and Acute Otitis Media in Children

JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 03/2011; 305(10):997; author reply 997-8. DOI: 10.1001/jama.2011.240
Source: PubMed
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    ABSTRACT: To determine the possible correlation between otitis media and dental malocclusion in children. Fifty subjects (26 males and 24 females; mean age: 7.8 +/- 1 years) were assessed: 25 patients, with otitis media formed the study group, while 25 healthy subjects formed the control group. An otolaryngological examination and dental cast measurements were performed in order to evaluate adenoids, tonsils and dental relationships, respectively. A significant correlation (p<0.05) was found between otitis media and enlargement of adenoids (13 patients, 52% in the study group) and tonsils (11 patients, 44% in the study group). Furthermore, a significant predominance (p<0.05) of posterior crossbite was found in the study group (19 children, 76%), in comparison to the control group (4 children, 16%). No correlation between otitis media and overjet, overbite, Angle Class relationship, or inadequate oral habits were found. Posterior cross-bite and adenoids-tonsils enlargement are factors significantly associated with otitis media in children.
    European Archives of Paediatric Dentistry. Official Journal of the European Academy of Paediatric Dentistry 10/2011; 12(5):241-4. DOI:10.1007/BF03262815
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    ABSTRACT: The epidemiology of pediatric fever has changed considerably during the past 2 decades with the development of vaccines against the most common bacterial pathogens causing bacteremia and meningitis. The decreasing incidence of these 2 conditions among vaccinated children has led to an emphasis on urinary tract infection as a remaining source of potentially hidden infections in febrile children. Emerging literature, however, has led to questions about both the degree and nature of the danger posed by urinary tract infection in nonverbal children, whereas the aggressive pursuit of the diagnosis consumes resources and leads to patient discomfort, medical risks, and potential overdiagnosis. We review both early and emerging literature to examine the utility and efficacy of early identification and treatment of urinary tract infection in children younger than 24 months. We conclude that in well children of this age, it may be reasonable to withhold or delay testing for urinary tract infection if signs of other sources are apparent or if the fever has been present for fewer than 4 to 5 days.
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