Otitis media in infants aged 0-8 weeks: Frequency of associated serious bacterial disease

Objective: To determine the frequency of serious bacterial infection in wel l appearing infants aged 0-8 weeks with isolated otitis media (OM). Methods: Infants with confirmed OM underwent tympanocentesis with middle ea r fluid (MEF) culture and complete sepsis evaluation. Enrolled infants were admitted to the hospital for parenteral antibiotics until blood, urine, an d CSF cultures were negative for 48 hours. Results: Forty non-toxic appearing infants were enrolled between January 19 94 and April 1995, of whom 15 (38%) had a documented rectal temperature gre ater than or equal to 38 degrees C. Bacterial pathogens were isolated from MEF cultures in 25 (62.5%) infants, All afebrile infants had negative blood , urine, and cerebrospinal fluid cultures (upper limit (UL) 95% CI 0.11), O nly-two febrile infants had positive cultures from sites other than the MEF (UL 95% CI 0.36), Conclusion: In our study population, previously healthy, non-toxic appearin g afebrile infants aged 2-8 weeks and having isolated OM infrequently have an associated serious bacterial infection, suggesting that outpatient treat ment with oral antibiotics and close follow-up may be an option. Further st udies with large numbers of infants are necessary to confirm this conclusio n.