Can Fam Physician. 1989 Sep;35:1841-4.
Acute otitis media is typified by the patient with fever, earache, and a "red" ear-drum. Suppurative otitis media, however, often presents without specific symptoms, and redness is the least reliable physical finding. Impaired tympanic membrane mobility on pneumatic otoscopy and bulging and opacification of the ear-drum are more reliable and important physical signs. Review of placebo-controlled trials reveals that antimicrobial therapy produces more rapid relief of fever and earache in patients with the most symptoms. Effects on patients with fewer symptoms are more modest. Amoxicillin remains the standard first-line treatment. Reasonable indications for alternative therapy are reviewed.
急性中耳炎的典型表现为患者有发热、耳部疼痛和“红”鼓膜。然而，化脓性中耳炎常无特定症状，且鼓膜红肿是最不可靠的体格检查结果。鼓气耳镜检查时鼓膜活动受限以及鼓膜膨隆和混浊是更可靠和重要的体格检查体征。对安慰剂对照试验的回顾显示，抗菌治疗可使症状最严重的患者更快地缓解发热和耳部疼痛。对症状较少的患者的疗效则较为温和。阿莫西林仍然是标准的一线治疗药物。本文回顾了替代治疗的合理适应证。
