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Has the watch-and-wait approach to managing children with acute otitis media (AOM) increased the incidence of mastoiditis? Investigators used a general practice U.K. database of more than 2.5 million children (age range, 3 months to 15 years) to examine trends in diagnosis of AOM and mastoiditis from 1990 through 2006.
Of 854 children with diagnoses of mastoiditis, only 36% had received diagnoses of AOM during the previous 3 months. During the 16-year study, the incidence of mastoiditis remained stable (average incidence, 1.2 per 10,000 child-years), whereas the incidence of AOM diagnoses declined 34%, and the proportion of children with AOM who were treated with antibiotics declined significantly from 77% to 58%. Risk for developing mastoid…