Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan.

OBJECTIVE To (1) indicate methods of diagnosis and testing for acute otitis media (AOM) in children (under 15 years of age); and (2) recommend methods of treatment in accordance with the evidence based consensus reached by the subcommittee on clinical practice guidelines for the diagnosis and management of AOM in children (subcommittee on clinical practice guidelines), in light of the causative bacteria of AOM in Japan and their susceptibility to antimicrobial agents. METHODS We investigated the most recently detected bacteria causing childhood AOM in Japan as well as their antimicrobial susceptibility, developed clinical questions concerning the diagnosis, testing methods, and treatment of AOM, searched the literature published during 2000-2004, and issued the 2006 guidelines. In the 2009 guidelines we performed the same investigation with the addition of literature that was published during 2005-2008 and that was not included in the 2006 guidelines. RESULTS We categorized AOM as mild, moderate, or severe on the basis of otoscopic findings and clinical symptoms, and presented a recommended treatment for each degree of severity. CONCLUSION Accurate assessment of otoscopic findings, as well as other signs and symptoms, is important for judging the degree of severity and selecting a method of treatment.