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Chapter 20 : Acute Otitis Media and Its Sequelae

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Abstract:

Acute otitis media (AOM) is one of the most commonly diagnosed infections of childhood in the industrialized world. The pathophysiology of mucosal pneumococcal infections such as AOM is different from that of invasive pneumococcal diseases (IPD) such as bacteremia and meningitis. A number of studies have evaluated the potential of pneumococcal conjugate vaccines (PCV) to prevent AOM and its complications. When evaluating the results of these studies, it is important to make a distinction between studies in which the subjects were vaccinated in early infancy and studies that enrolled older children with a history of previous attacks of otitis media. In an uncomplicated case of AOM, the signs and symptoms of the acute infection are usually relieved within a few days after the onset of the attack and the potential initiation of antimicrobial therapy, and the middle ear effusion resolves within a few weeks. The reduction of recurrent AOM, tympanostomy tube placements, and otitis media with effusion (OME) demonstrated in the PCV otitis media efficacy studies indicates that PCV may have the strongest impact on complicated AOM. New PCV providing improved efficacy against pneumococcal serotypes included in the current vaccines and broader protection against the most relevant pneumococcal serotypes and nonpneumococcal bacterial pathogens such as would have a greater impact on AOM and its sequelae than current PCV and may even prevent this microbiological shift.

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20

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Figure 1

Number of AOM episodes in the POET study groups by bacterial AOM pathogen and impact of PCV11-PD. S. pn. 7VT, serotype 4, 6B, 9V, 14, 18, 19F, and 23F; VRT, 7VT-related serotypes; NVT, other serotypes; H. inf., ; M. cata, ; others, other bacterial AOM pathogens; neg, culture-negative AOM episode.

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
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References

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Tables

Generic image for table
Table 1

Randomized, double-blind, controlled trials evaluating the efficacy of PCV immunization initiated in the first year of life against various types of otitis media

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
Generic image for table

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
Generic image for table
Table 2

Impact of PCV7-CRM on overall AOM in infants

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
Generic image for table
Table 3

Impact of PCV7-CRM and PCV7-OMP in infants on culture-confirmed bacterial AOM end points in the FinOM study

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
Generic image for table
Table 4

Impact of PCV11-PD in infants on overall AOM and culture-confirmed bacterial AOM end points in the POET study

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
Generic image for table
Table 5

Randomized, controlled trials evaluating the impact of PCV immunization initiated after the first year of life

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20
Generic image for table

Citation: Kilpi T, Schuerman L. 2008. Acute Otitis Media and Its Sequelae, p 301-315. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch20

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