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 health outcomes.

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.