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Acute otitis media (AOM) stands as a prevalent childhood illness, frequently necessitating antibiotic treatment. Its burden is significant, affecting about 80% of children under 3 years old, with approximately 40% experiencing recurrent episodes by age 3. In a study spanning European countries, including Lithuania, middle ear otitis occurred at a rate of 160.7 cases per 100,000 children per year. Post-pneumococcal conjugate vaccine (PCV) implementation, causative agents shifted towards non-vaccine pneumococcal types and Haemophilus influenzae. Antibiotic prescription rates, as noted from surveys of European pediatricians, range up to 78% for otitis media with effusion (OME). Commonly prescribed medications include amoxicillin (88.5%), amoxicillin-clavulanate (7.8%), cephalosporins (3.4%), and macrolides (0.3%). Despite similar antibiotic prescription frequencies in Eastern Europe and the Baltic, prescription practices differ, influenced by active otitis monitoring. In this review article, we care to provide up to date critical review of the literature on AOM prevalence, most common pathogens and antimicrobial resistance. Conclusions and recommendations. The most common pathogens of acute otitis media are Streptococcus pneumoniae and Haemophilus influenzae, with S. pneumoniae often showing resistance to penicillin and erythromycin, while H. influenzae tends to be resistant primarily to ampicillin and amoxicillin when combined with clavulanic acid; however, due to increased PCV vaccination, H. influenzae is becoming more prevalent, especially among patients unresponsive to first-line treatment with amoxicillin, often due to β-lactamase-producing strains.
Juozapavičiūtė et al. (Sun,) studied this question.