Summary An international group of multidisciplinary experts on middle-ear and paediatric infections met to explore where consensus exists on the management of acute otitis media. After informal ...discussions among several specialists of paediatric infectious disease, the group was expanded to include a larger spectrum of professionals with complementary expertise in middle-ear disease. Acute otitis media is a very common bacterial infection in children worldwide, leading to excessive antibiotic consumption in children in most countries and to a substantial burden of deafness and suppurative complications in developing countries. The group attempted to move beyond the existing controversies surrounding guidelines on acute otitis media, and to propose to clinicians and public health officials their views on the actions needed to be taken to reduce the disease burden caused by acute otitis media and the microbial antibiotic resistance from the resulting use of antibiotics. Definition of acute otitis media and diagnostic accuracy are crucial steps to identify children who will potentially benefit from treatment with antibiotics and to eliminate unnecessary prescribing. Although the group agreed that antibiotics are distributed indiscriminately, even to children who do not seem to have the disease, no consensus could be reached on whether antibiotics should be given to all appropriately diagnosed children, reflecting the wide range of practices and lack of convincing evidence from observational studies. The major unanimous concern was an urgent need to reduce unnecessary prescribing of antibiotics to prevent further increases in antibiotic resistance. Prevention of acute otitis media with existing and future viral and bacterial vaccines seems the most promising approach to affect disease burden and consequences, both in developed and developing countries.
Highlights ► Global Vaccine Safety Blueprint Strategy developed in 2011. ► Strategy is based on landscape analysis of vaccine safety stakeholders and systems. ► Strategy aims at minimal and enhanced ...country capacity and global support network. ► Global Vaccine Safety Initiative launched 2012, supports implementation of Strategy. ► Decade of Vaccines is opportunity to raise awareness for Blueprint implementation.
...the Advisory Committee on Immunization Practices (ACIP) has recommended routine immunization of pregnant women with influenza vaccine since 1997 2 and a dose of Tdap during every pregnancy since ...2012 4. ...the World Health Organization (WHO) and Brighton Collaboration jointly convened a meeting in July 2014 to develop Brighton Collaboration definitions of key terms used for monitoring the safety of immunization in pregnant women and infants 17.
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