Documento de consenso sobre etiología, diagnóstico y tratamiento de la otitis media aguda

This is the consensus document on acute otitis media (AOM) of the Sociedad Española de Infectología Pediatrica (SEIP), Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP), Sociedad Española de Urgencias Pediátricas (SEUP) and Asociación Española de Pediatría de Atención Primaria (AEPAP). It discusses the aetiology of the disease and its potential changes after the introduction of the pneumococcal 7-valent, 10-valent and 13-valent vaccines. A proposal is made based on diagnostic classification of otitis media as either confirmed or likely. AOM is considered confirmed if 3 criteria are fulfilled: acute onset, signs of occupation of the middle ear (or otorrhea) and inflammatory signs or symptoms, such as otalgia or severe tympanic hyperaemia. Oral amoxicillin is the antibiotic treatment of choice (80 mg/kg/day divided every 8 hours). Amoxicillin-clavulanate (80 mg/kg/day) is indicated in the following cases: when the child is under 6 months, in infants with severe clinical manifestations (fever > 39° C or severe pain), there is family history of AOM sequels, and after amoxiciline treatment failure.