Acute otitis media (AOM) is a highly
prevalent and costly disease that
affects young children, their caregivers,
and managed care plans. Although the
predominant pathogenic organisms in AOM
are Haemophilus influenzae, Streptococcus
pneumoniae, and Moraxella catarrhalis, a
proportional change in the prevalence of
these organisms has recently occurred. As
such, traditional empiric therapy for AOM
management has been brought into question.
This supplement to The American Journal of
Managed Care will review evidence of a shift
in the microbiology of AOM and discuss the
clinical and economic implications of such a
shift for a managed care audience.
The supplement begins with Michael E.
Pichichero, MD, exploring the background
and events leading up to and presents evidence
of a proportional shift in the microbiology
of AOM. In his article, Dr Pichichero
discusses in detail the clinical consequences
and the future implications of the shift, and
describes why these factors should be considered
by managed care professionals.
In the next article, Diana I. Brixner, RPh,
PhD, reviews the total costs of AOM and
the cost implications of the shift in microbiology
of AOM to the managed care audience.
This article also reviews prescription
antibiotic use in AOM, presents evidence
of the clinical and economic impact of
antibiotic adherence, and compares antibiotic
profiles for several factors that can
affect antibiotic adherence and subsequent
Together, these articles provide valuable
information that managed care professionals
and physicians can use to evaluate and compare
the clinical and economic differences
among antibiotic therapies for managing the
shifting microbiological environment of AOM.