[Child acute otitis media].

Most frequent complication of children upper respiratory tract infections, acute otitis media is the leading cause of bacterial infections and one of the leading causes of antibiotic prescriptions. Under the combined effect of Prevenar immunization and the reduction of the use of antibiotics in France, the highly resistant strains of pneumococci (those which posed therapeutic problems) decreased moreover of the three quarter. Non typable H. influenzae became the main bacteria responsible of AOM, and resistance to the beta-lactams by change of penicillin binding proteins is an emergent problem in France. The diagnosis of purulent OMA is based on a triad: recent onset functional (otalgia) and generals (fever) signs, middle ear effusion and tympanic membrane inflammation. The official French guidelines suggest prescribing antibiotics (amoxicillin-acid clavulanate-cefpodoxime proxetil) only for purulent acute otitis media diagnosed in an unquestionable way, systematically in the child of less than two years, only for the most symptomatic forms after this age, while making use of the history and the clinical and bacteriological correlations to choose antibiotic.