PROGNOSIS OF ACUTE OTITIS-MEDIA - FACTORS ASSOCIATED WITH POOR OUTCOME

Factors associated with poor outcome of acute otitis media (AOM) were analysed in 131 children aged 1/4 to 7 1/2 (median 21/2) years. After AOM, altogether 37 (28%) of the children had poor outcome: 15 children (12%) clinical failure (unimprovement or worsening of pre-treatment s igns and symptoms within 2 weeks of onset of therapy) and 31 (24%) per sistent middle ear effusion (MEE) greater than or equal to 1 month pos t-treatment. Of the different variables studied in multivariate analys is, age <2 years (p < 0.01), history of allergic skin or respiratory s ymptoms (p = 0.02), greater than or equal to 6 h duration of pre-treat ment earache (p = 0.01) and B. catarrhalis in MEE (p = 0.05) were asso ciated with clinical failure. Children with previous adenotomy or unil ateral AOM had no failures. Persistence of MEE at 1 month was associat ed with age <2 years (p = 0.05), otitis proneness (p = 0.03), bilatera lity of AOM (p < 0.01) and S. pneumoniae in MEE (p = 0.01) in univaria te but not in multivariate analysis.