Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study

Aim and background: Acute otitis media (AOM) and otitis media with effusion (OME) are common childhood ear infections. The changing epidemiological landscape in India and growing concerns about antimicrobial resistance underscore the need for evidence-based, updated guidance on management. This expe...

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Main Authors: Tanu Singhal, Shyam Kukreja, Jaydeep Choudhury, Vijay Yewale, Balasubramanian Sundaram, Jagdish Chinnappa, Suhas Prabhu, Balaji Veeraraghavan, Camilla Rodrigues, Vidya Krishna, Winsley Rose, Samir Bhargava
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2024-05-01
Series:Pediatric Infectious Disease
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Online Access:https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1426
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author Tanu Singhal
Shyam Kukreja
Jaydeep Choudhury
Vijay Yewale
Balasubramanian Sundaram
Jagdish Chinnappa
Suhas Prabhu
Balaji Veeraraghavan
Camilla Rodrigues
Vidya Krishna
Winsley Rose
Samir Bhargava
author_facet Tanu Singhal
Shyam Kukreja
Jaydeep Choudhury
Vijay Yewale
Balasubramanian Sundaram
Jagdish Chinnappa
Suhas Prabhu
Balaji Veeraraghavan
Camilla Rodrigues
Vidya Krishna
Winsley Rose
Samir Bhargava
author_sort Tanu Singhal
collection DOAJ
description Aim and background: Acute otitis media (AOM) and otitis media with effusion (OME) are common childhood ear infections. The changing epidemiological landscape in India and growing concerns about antimicrobial resistance underscore the need for evidence-based, updated guidance on management. This expert consensus using the Delphi methodology was undertaken to deliberate and consolidate statements to guide the management of AOM and OME in India. Methods: A panel of 12 experts comprising pediatric infectious disease specialists, clinical microbiologists, and ear, nose, and throat (ENT) specialists participated in a three-step modified Delphi study conducted between April 2023 and January 2024. Overall, 101 statements were derived from an extensive literature search and shared with the experts for their response in the form of “yes” or “no” during round 1. Statements lacking consensus (predefined as <80% agreement) in round 1 were reevaluated in round 2, following a similar process for reaching consensus. Statements pending consensus in round 2 were then discussed in a virtual meeting (round 3). Results: A total of 83/101 (82.2%) statements in round 1 and 15/18 (83.33%) statements in round 2 achieved consensus (≥80% agreement) among the experts. A few statements were revised and updated based on the inputs from the experts, and 23 statements were deliberated in the virtual discussion during round 3. Finally, experts agreed to include 67 statements pertaining to risk factors, resistant strains, conservative and symptomatic management, and antibiotic treatment algorithms for AOM and OME. Conclusion: The consensus recommendations provide systematic guidance to clinicians on the appropriate management of AOM and OME. Clinical significance: These recommendations encompass stepwise interventions and address initial treatment as well as potential scenarios of treatment failure or recurrence in AOM and OME.
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spelling doaj-art-de631bfd3b084e698f0b5ce3574a39af2025-02-07T11:21:15ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882024-05-0162404810.5005/jp-journals-10081-14262Expert Consensus on the Management of Acute Otitis Media in India: A Delphi StudyTanu Singhal0Shyam Kukreja1Jaydeep Choudhury2Vijay Yewale3Balasubramanian Sundaram4Jagdish Chinnappa5Suhas Prabhu6Balaji Veeraraghavan7Camilla Rodrigues8Vidya Krishna9Winsley Rose10Samir Bhargava11Department of Pediatrics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India, Phone: +91 9320211770Department of Pediatrics, Max Super Speciality Hospital, Patparganj, Delhi, IndiaDepartment of Pediatrics, Institute of Child Health, Kolkata, West Bengal, IndiaDepartment of Pediatrics, Apollo Hospital, Mumbai, Maharashtra, IndiaDepartment of Pediatrics, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, Tamil Nadu, IndiaDepartment of Pediatrics, Child Central Clinic, Bengaluru, Karnataka, IndiaDepartment of Pediatrics, P. D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, IndiaDepartment of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Pediatrics, P. D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, IndiaDepartment of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, IndiaDepartment of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Pediatrics, P. D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, IndiaAim and background: Acute otitis media (AOM) and otitis media with effusion (OME) are common childhood ear infections. The changing epidemiological landscape in India and growing concerns about antimicrobial resistance underscore the need for evidence-based, updated guidance on management. This expert consensus using the Delphi methodology was undertaken to deliberate and consolidate statements to guide the management of AOM and OME in India. Methods: A panel of 12 experts comprising pediatric infectious disease specialists, clinical microbiologists, and ear, nose, and throat (ENT) specialists participated in a three-step modified Delphi study conducted between April 2023 and January 2024. Overall, 101 statements were derived from an extensive literature search and shared with the experts for their response in the form of “yes” or “no” during round 1. Statements lacking consensus (predefined as <80% agreement) in round 1 were reevaluated in round 2, following a similar process for reaching consensus. Statements pending consensus in round 2 were then discussed in a virtual meeting (round 3). Results: A total of 83/101 (82.2%) statements in round 1 and 15/18 (83.33%) statements in round 2 achieved consensus (≥80% agreement) among the experts. A few statements were revised and updated based on the inputs from the experts, and 23 statements were deliberated in the virtual discussion during round 3. Finally, experts agreed to include 67 statements pertaining to risk factors, resistant strains, conservative and symptomatic management, and antibiotic treatment algorithms for AOM and OME. Conclusion: The consensus recommendations provide systematic guidance to clinicians on the appropriate management of AOM and OME. Clinical significance: These recommendations encompass stepwise interventions and address initial treatment as well as potential scenarios of treatment failure or recurrence in AOM and OME.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1426acute otitis mediaantibioticsexpert consensusindiaotitis media with effusion
spellingShingle Tanu Singhal
Shyam Kukreja
Jaydeep Choudhury
Vijay Yewale
Balasubramanian Sundaram
Jagdish Chinnappa
Suhas Prabhu
Balaji Veeraraghavan
Camilla Rodrigues
Vidya Krishna
Winsley Rose
Samir Bhargava
Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study
Pediatric Infectious Disease
acute otitis media
antibiotics
expert consensus
india
otitis media with effusion
title Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study
title_full Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study
title_fullStr Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study
title_full_unstemmed Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study
title_short Expert Consensus on the Management of Acute Otitis Media in India: A Delphi Study
title_sort expert consensus on the management of acute otitis media in india a delphi study
topic acute otitis media
antibiotics
expert consensus
india
otitis media with effusion
url https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1426
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