From the Guidelines
Suppurative otitis media refers to a middle ear infection characterized by the accumulation of pus in the middle ear space, typically presenting with ear pain, fever, hearing loss, and sometimes drainage from the ear if the eardrum ruptures, as defined in the study by 1. This condition is a type of otitis media, which is a spectrum of diseases including acute otitis media, otitis media with effusion, and chronic suppurative otitis media, as discussed in the study by 2. The infection occurs when bacteria enter the middle ear through the Eustachian tube, often following a viral upper respiratory infection that causes swelling and blockage of this drainage pathway, leading to fluid accumulation and bacterial growth in the normally air-filled middle ear space, as explained in the study by 1. Key points to consider in the management of suppurative otitis media include:
- Accurate diagnosis to reduce over-diagnosis, overtreatment, and antibiotic resistance, as emphasized in the study by 3
- Treatment with antibiotics, such as amoxicillin, for uncomplicated cases in children, or amoxicillin-clavulanate for more resistant infections, as discussed in the study by 2
- Pain management with acetaminophen or ibuprofen, as mentioned in the study by 1
- Consideration of surgical options, such as tympanostomy tubes, for recurrent or persistent cases, as discussed in the study by 4 It is essential to prioritize prompt medical attention to prevent complications, such as hearing loss, mastoiditis, or spread of infection to surrounding structures, as highlighted in the study by 2.
From the Research
Definition of Suppurative Otitis Media
- Suppurative otitis media is a chronic inflammation and infection of the middle ear and mastoid cavity, characterized by ear discharge (otorrhoea) through a perforated tympanic membrane 5, 6.
- The predominant symptoms of suppurative otitis media are ear discharge and hearing loss 5, 6.
Causes and Treatment
- Suppurative otitis media is often caused by a polymicrobial infection, involving more than one micro-organism 6.
- Antibiotics are the most common treatment for suppurative otitis media, which act to kill or inhibit the growth of micro-organisms that may be responsible for the infection 5, 6.
- Antibiotics can be administered both topically and systemically, and can be used alone or in addition to other treatments for suppurative otitis media such as ear cleaning (aural toileting) 5, 6.
Comparison of Topical and Systemic Antibiotics
- There is limited evidence available to examine whether topical or systemic antibiotics are more effective in achieving resolution of ear discharge for people with suppurative otitis media 6.
- However, amongst this uncertainty, there is some evidence to suggest that the topical administration of antibiotics may be more effective than systemic administration of antibiotics in achieving resolution of ear discharge (dry ear) 6.