Acute otitis media (AOM) in children represents a public health concern, being one of the leading causes of health care visits and antibiotic prescriptions worldwide. The overall aim of this paper is to unravel the major current insights into the antibiotic treatment of AOM in children. Our approach is three-fold: 1. a preclinical evaluation of antibiotics in animal models of AOM stressing on the advantages of different species when testing for different schemes of antibiotics; 2. an overview on the new antimicrobial agents whose efficacy has been demonstrated in refractory cases of AOM in children; and 3. an analysis of the different guidelines stressing on the differences and similarities between the various schemes of antibiotic treatment. The preferred therapeutic agents remain amoxicillin and the amoxicillin-clavulanate combination for AOM caused by Streptococcus pneumoniae, whereas oral cephalosporin is preferred in AOM due to Moraxella catarrhalis and Haemophilus influenzae. As for the second and third line antimicrobial treatments, there is a wide variety of suggested antibiotic classes with variations in duration and posology. The decision to prescribe antimicrobial treatment as a first-line choice is based on the severity of the symptoms in 16 of the guidelines included in this review.

中文翻译：

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从证据到儿童急性中耳炎抗生素治疗的临床指南


儿童急性中耳炎 (AOM) 是一个公共健康问题，是全世界就诊和开抗生素处方的主要原因之一。本文的总体目的是阐明当前对儿童 AOM 抗生素治疗的主要见解。我们的方法有三个方面：1.在AOM动物模型中对抗生素进行临床前评估，在测试不同的抗生素方案时强调不同物种的优势； 2. 已在儿童难治性 AOM 病例中证实有效的新型抗菌药物概述； 3. 对不同指南的分析，强调不同抗生素治疗方案之间的差异和相似之处。对于由肺炎链球菌引起的 AOM，优选的治疗药物仍然是阿莫西林和阿莫西林-克拉维酸组合，而对于由卡他莫拉菌和流感嗜血杆菌引起的 AOM，口服头孢菌素是优选的。至于二线和三线抗菌治疗，有多种建议的抗生素类别，其持续时间和剂量各不相同。将抗菌药物治疗作为一线选择的决定是基于本综述中 16 条指南中症状的严重程度。