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Hospitalization for Acute Otitis Media as a Useful Marker for Disease Severity

Kvaerner, Kari Jorunn MD, PhD*†; Austeng, Marit Erna MD*‡; Abdelnoor, Michael MPH, PhD§

The Pediatric Infectious Disease Journal: September 2013 - Volume 32 - Issue 9 - p 946–949
doi: 10.1097/INF.0b013e318297c436
Original Studies

Background: An increase in severe complications to otitis media is a potential threat to antibiotic restrictions and is difficult to measure due to its low-prevalent nature. Easily accessible indicators sensitive to illness change are needed to benchmark the judicious use of antibiotics.

Objective: To investigate whether there has been a constant increase of hospital admissions for acute otitis media after the year 2000.

Methods: Registry-based study with complete data on hospitalization for acute otitis media and acute mastoiditis in Norway during 1999 to 2006.

Results: Mean incidence rate for acute otitis media hospitalization was 22.4 per 10,000 children and peak incidence in the second year of life 52.2 per 10,000 children. Corresponding mean incidence rate and peak incidence for acute mastoiditis were 1.5 and 3.5 per 10,000 children in the second year of life, respectively. There was a gradient increase of the incidence rates of acute otitis media hospitalization from the year 2000 to 2006 considering the Poisson regression model with a significant test of linear trend.

Conclusions: Hospital admission for acute otitis media is prevalent enough to be a useful marker for otitis media severity and its distribution proportionate to that of acute mastoiditis.

From the *Department of Health Management and Health Economics, University of Oslo; Research, Innovation and Education, Oslo University Hospital, Ullevål; Department of Otolaryngology, Ostfold Hospital Trust; and §Centre of Clinical Research, Unit of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.

Accepted for publication April 18, 2013.

K.J.K. contributed to study design, data collection, data interpretation and the report of the work described in the article and is responsible of the overall content as guarantor. M.E.A. contributed to data collection and review of the article. M.A. contributed to statistical analysis and the report of the work described in the article.

Supported by University of Oslo. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Kari Jorunn Kvaerner, MD, PhD, Oslo University Hospital, Kirkeveien 166, N-0407 Oslo, Norway. E-mail:;

© 2013 by Lippincott Williams & Wilkins, Inc.