Incidence of Acute Otitis Media in Adults
The incidence of acute otitis media (AOM) in adults is approximately 3.6-4 cases per 100 adults per year, which is significantly lower than the incidence in children but still represents a substantial disease burden. 1
Epidemiology of AOM in Adults vs. Children
The global burden of AOM shows clear age-related patterns:
- Adult incidence: 3.6-4 cases per 100 people per year in regions like central Europe 1
- Child incidence: Much higher, with peak rates in children 1-4 years of age (61 new episodes per 100 children per year) 1
- Global average: 10.8 new episodes per 100 people per year across all age groups 1
The geographic distribution of AOM incidence varies considerably:
- Lower rates in developed regions (3.6 per 100 in central Europe)
- Higher rates in developing regions (up to 43.4 per 100 in Sub-Saharan West Africa) 1
Clinical Differences Between Adult and Pediatric AOM
Adults with AOM present differently than children:
Adults typically:
- Seek care more quickly after symptom onset
- More frequently report ear pain, decreased hearing, sore throat, and ear discharge
- Have higher rates of previous tonsillectomy or adenoidectomy 2
Children typically:
- Present with recent upper respiratory infections
- More frequently have fever, diarrhea, and vomiting
- Show more pronounced tympanic membrane redness and bulging 2
Risk Factors for AOM in Adults
Several factors increase the risk of AOM in adults:
- History of recurrent ear infections
- Increasing age (associated with poorer outcomes)
- Upper respiratory tract infections
- Eustachian tube dysfunction 2
Prognosis and Complications
The prognosis for adults with AOM differs from children:
- Adults have higher rates of poor outcomes at 2 months compared to children
- Recovery appears more related to individual patient characteristics and history than to antibiotic therapy 2
- Risk of complications increases with age and number of previous AOM episodes 2
Management Considerations
While the primary focus of most guidelines is on pediatric AOM, management principles for adults include:
- Symptomatic management of ear pain is the mainstay of treatment
- Antibiotics should be reserved for severe cases or those with high risk of complications
- Tympanic membrane perforation is a potential complication that occurs in both adults and children 1
Public Health Impact
Despite lower incidence in adults compared to children, adult AOM represents a significant healthcare burden:
- Of 22 million annual visits for AOM in the United States, approximately 4 million (18%) are by patients 15 years or older 2
- This contributes to substantial healthcare utilization and antibiotic prescribing
Understanding the epidemiology of AOM across all age groups is essential for appropriate resource allocation and development of treatment guidelines that address both pediatric and adult populations.