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176 C. Montero
• Amoxicilina-clavulánico 80-90 mg/kg/día.
Duración del tratamiento: 10-14 días.
Tratamiento quirúrgico
Mastoidectomía:siempre que exista osteítis,si no existe mejoría o empeora del
cuadro a pesar de antibioterapia iv en 48 horas.
Siempre consultar a otorrinolaringólogo para valorar indicación de tratamien-
to quirúrgico.
BIBLIOGRAFÍA
1. Agrawal S, Husein M, MacRae D. Complications of otitis media: an evolving state. J Otolaryngol
2005;34(Suppl 1): S33-9.
2. American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis
and management of acute otitis media. Pediatrics 2004;113(5): 1451-65.
3. Berman S. Otitis media in developing countries. Pediatrics 1995;96(1Pt !):126-31.
4. Del Castillo F, Baquero AF, García PA: Influence of recent antibiotic therapy on antimicrobial resistan-
ce of Streptococcus pneumoniae in children with acute otitis media in Spain. Pediatr Infect Dis J
1998;17(2):94-97.
5. Cincinnati Children´s Hospital Medical Center. Evidence based clinical practice guideline for Otitis
Media in children 2 months to 6 years of age. March, 1999.
6. Damoiseaux RA,van Balen FA,Hoes AW,de Melker RA.Primary care based randomised,double blind
trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ
2000;320(7231):350-354.
7. Department of Pediatrics Children´s Hospital of Pittsburgh University of Pittsburgh School of Medi-
cine.To treat or not to treat. Pediatrics 2005;115(4):1087-1089.
8. Dominguez RS, Mainou CC, Claros BA, Latorre OC, Camarasa PF, Corretger Rauet JM. Clinical and
microbiological study of otitis media in infants.An Esp Pediatr 1996; 44(4): 341-344.
9. Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B.Principles of judicious use of antimicrobial
agents for pediatric upper respiratory tract infections. Pediatrics 1998; 101(1 II Suppl.):165-171.
10. Garbutt J,St Geme JW 3rd,May A,Storch GA,Shackelford PG.Developing community-specific recom-
mendations for first-line treatment of acute otitis media:is high-dose amoxicillin necessary? Pediatrics
2004;114(2):342-7.
11. Kaplan SL,Mason EO Jr,Wald ER,Kim KS,Givner LB,Bradley JS;Barson WJ,Tan TQ,Schutze GE,Yogev
R. Peumococcal mastoiditis in children. Pediatrics 2000;106(4): 695-9.
12. Klein JO. Management of acute otitis media in an era of increasing antibiotic resistance. Int J Pediatr
Otorhinolaryngol 1999;49(Suppl 1):S15-S17.
13. Leiborvitz E,Piglansky L,Raiz S,Greenberg D,Yagupsky P,Press J et al.Bacteriologic efficacy of a three-
day intramuscular ceftriaxone regimen in nonresponsive acute otitis media. Pediatr Infect Dis J
1998;17(12):1126-1131.
14. Martín Muñoz P, Ruiz-Canela Cáceres J. Manejo de la otitis media aguda en la infancia. Guía de prácti-
ca clínica basada en la evidencia.Agencia de Evaluación de Tecnologías Sanitarias de Andalucía 2001.
15. McCormick DP, Chonmaitree T, Pittman C, Saeed K, Friedman NR; Uchida T, Baldwin CD. Nonseve-
re acute otitis media: a clinical trial comparing outcomes of watchful waiting versus inmediate anti-
biotic treatment. Pediatrics 2005;115(6):1455-65.
16. Mross-Adam C, Klemm E.Acute mastoiditis in children, a retrospective analysis about a period of 25
years. Laryngorhinootologie 2005;84(7):497-502.
176 C. Montero
• Amoxicilina-clavulánico 80-90 mg/kg/día.
Duración del tratamiento: 10-14 días.
Tratamiento quirúrgico
Mastoidectomía:siempre que exista osteítis,si no existe mejoría o empeora del
cuadro a pesar de antibioterapia iv en 48 horas.
Siempre consultar a otorrinolaringólogo para valorar indicación de tratamien-
to quirúrgico.
BIBLIOGRAFÍA
1. Agrawal S, Husein M, MacRae D. Complications of otitis media: an evolving state. J Otolaryngol
2005;34(Suppl 1): S33-9.
2. American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis
and management of acute otitis media. Pediatrics 2004;113(5): 1451-65.
3. Berman S. Otitis media in developing countries. Pediatrics 1995;96(1Pt !):126-31.
4. Del Castillo F, Baquero AF, García PA: Influence of recent antibiotic therapy on antimicrobial resistan-
ce of Streptococcus pneumoniae in children with acute otitis media in Spain. Pediatr Infect Dis J
1998;17(2):94-97.
5. Cincinnati Children´s Hospital Medical Center. Evidence based clinical practice guideline for Otitis
Media in children 2 months to 6 years of age. March, 1999.
6. Damoiseaux RA,van Balen FA,Hoes AW,de Melker RA.Primary care based randomised,double blind
trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ
2000;320(7231):350-354.
7. Department of Pediatrics Children´s Hospital of Pittsburgh University of Pittsburgh School of Medi-
cine.To treat or not to treat. Pediatrics 2005;115(4):1087-1089.
8. Dominguez RS, Mainou CC, Claros BA, Latorre OC, Camarasa PF, Corretger Rauet JM. Clinical and
microbiological study of otitis media in infants.An Esp Pediatr 1996; 44(4): 341-344.
9. Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B.Principles of judicious use of antimicrobial
agents for pediatric upper respiratory tract infections. Pediatrics 1998; 101(1 II Suppl.):165-171.
10. Garbutt J,St Geme JW 3rd,May A,Storch GA,Shackelford PG.Developing community-specific recom-
mendations for first-line treatment of acute otitis media:is high-dose amoxicillin necessary? Pediatrics
2004;114(2):342-7.
11. Kaplan SL,Mason EO Jr,Wald ER,Kim KS,Givner LB,Bradley JS;Barson WJ,Tan TQ,Schutze GE,Yogev
R. Peumococcal mastoiditis in children. Pediatrics 2000;106(4): 695-9.
12. Klein JO. Management of acute otitis media in an era of increasing antibiotic resistance. Int J Pediatr
Otorhinolaryngol 1999;49(Suppl 1):S15-S17.
13. Leiborvitz E,Piglansky L,Raiz S,Greenberg D,Yagupsky P,Press J et al.Bacteriologic efficacy of a three-
day intramuscular ceftriaxone regimen in nonresponsive acute otitis media. Pediatr Infect Dis J
1998;17(12):1126-1131.
14. Martín Muñoz P, Ruiz-Canela Cáceres J. Manejo de la otitis media aguda en la infancia. Guía de prácti-
ca clínica basada en la evidencia.Agencia de Evaluación de Tecnologías Sanitarias de Andalucía 2001.
15. McCormick DP, Chonmaitree T, Pittman C, Saeed K, Friedman NR; Uchida T, Baldwin CD. Nonseve-
re acute otitis media: a clinical trial comparing outcomes of watchful waiting versus inmediate anti-
biotic treatment. Pediatrics 2005;115(6):1455-65.
16. Mross-Adam C, Klemm E.Acute mastoiditis in children, a retrospective analysis about a period of 25
years. Laryngorhinootologie 2005;84(7):497-502.
