Early-onset AOM linked to recurrences among Dutch children
Initial occurrence of acute otitis media at a younger age, particularly before age 9 months, was strongly associated with recurrent acute otitis media and full health care use during childhood, according to Dutch study findings.
“Early-onset [acute otitis media (AOM)] has been suggested as a risk factor for subsequent episodes of AOM, otitis media with effusion and atopic diseases during early childhood and may consequently increase the use of health care resources,” Marieke L.A. de Hoog, PhD, assistant professor in the Julius Center for Health Science and Primary Care at University Medical Center in Utrecht, Netherlands, and colleagues wrote. “It has long since been recognized that early-onset AOM is associated in more AOM episodes in the first 3 years of age. … however, results have not been confirmed when longer follow-up periods are studied.”
To identify the ages at which AOM is most critical and to quantify the long-term consequences of early-onset illness, de Hoog and colleagues followed children enrolled in the WHISTLER study up to age 6 years. The patients (n = 2,026) lived in Utrecht, were born from December 2001 to December 2012, and 39% experienced one or more episodes of AOM before they were aged 2 years.
The researchers observed an association between each 1-month decrease in the age of first AOM episode and an increase in the risk for multiple AOM recurrences (adjusted RR = 1.06; 95% CI, 1.02-1.1), considered at least three episodes in 6 months or at least 4 in 1 year. They also saw similar trends in an increased risk for a specialist referral (aRR = 1.16; 95% CI, 1.07-1.27) and total AOM events requiring primary care consultations (aRR = 1.08; 95% CI, 1.03-1.15).
“On the basis of our findings, children experiencing a first AOM at younger than 9 month of age can be considered high risk, and a more tailored management approach may be appropriate for these children,” de Hoog and colleagues wrote. “Future research is needed to establish whether such tailored AOM management of early-life AOM or other novel preventive strategies provide benefit over care as usual.” – by Kate Sherrer
Disclosure: de Hoog reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.