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Outpatient management of acute mastoiditis with periosteitis in children.

Abstract
Children with acute mastoiditis with periosteitis are conventionally hospitalized for parenteral antibiotics and/or surgical treatment. However, if possible, effective and safe outpatient treatment is desirable. During a 36-month period, outpatient parenteral antibiotic therapy (once daily i.m. ceftriaxone) was evaluated in 32 children with acute mastoiditis, with clinical evidence of periosteitis. Inclusion criteria included otomicroscopic evidence of acute otitis media (AOM), displacement of the pinna, retroauricular swelling, erythema and tenderness. The treatment consisted of wide myringotomy and administration of i.m. antibiotics. Daily visits, by a combined team of an otolaryngologist and pediatric infectious disease specialist, were considered essential. Fourteen children (43%) were treated initially in the hospital (and subsequently as outpatients) and 18 (57%) children were treated entirely as outpatients. Mean duration of outpatient treatment was 7 days (range: 4-10). The overall clinical cure rate was 96.8%. One child underwent simple mastoidectomy. No serious side effects were observed. Our data suggests that many children with acute mastoiditis with periosteitis can be managed successfully and safely as outpatients by a combined team of otolaryngologists and infectious disease specialists.
AuthorsA Niv, M Nash, J Peiser, R Dagan, M Einhorn, A Leiberman, D M Fliss
JournalInternational journal of pediatric otorhinolaryngology (Int J Pediatr Otorhinolaryngol) Vol. 46 Issue 1-2 Pg. 9-13 (Nov 15 1998) ISSN: 0165-5876 [Print] Ireland
PMID10190699 (Publication Type: Journal Article)
Chemical References
  • Cephalosporins
  • Ceftriaxone
Topics
  • Acute Disease
  • Ambulatory Care
  • Ceftriaxone (therapeutic use)
  • Cephalosporins (therapeutic use)
  • Child, Preschool
  • Female
  • Hospitalization
  • Humans
  • Male
  • Mastoid (surgery)
  • Mastoiditis (drug therapy, surgery)
  • Periostitis (drug therapy, surgery)
  • Time Factors
  • Treatment Outcome
  • Tympanic Membrane (surgery)

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