<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0026-1742</journal-id>
<journal-title><![CDATA[Revista de la Facultad de Medicina (México)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Fac. Med. (Méx.)]]></abbrev-journal-title>
<issn>0026-1742</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0026-17422017000100050</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Otitis Media Aguda. Un enfoque clínico y terapéutico]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute otitis media: A clinical and therapeutic approach]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez Marín]]></surname>
<given-names><![CDATA[Jorge Yolik]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Merelo Arias]]></surname>
<given-names><![CDATA[Carlos Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez Dórame]]></surname>
<given-names><![CDATA[Renzo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Strassburger Lona]]></surname>
<given-names><![CDATA[Karla]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez Díaz]]></surname>
<given-names><![CDATA[Carlos de Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional Autónoma de México Facultad de Medicina Departamento de Integración de Ciencias Médicas]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional Autónoma de México Facultad de Estudios Superiores Iztacala Hospital Ángeles Acoxpa]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Sonora Departamento de Medicina y Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Hermosillo Sonora]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<volume>60</volume>
<numero>1</numero>
<fpage>50</fpage>
<lpage>58</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0026-17422017000100050&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0026-17422017000100050&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0026-17422017000100050&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La otitis media aguda (OMA) es una enfermedad con alta prevalencia a nivel mundial principalmente en pacientes en edad pediátrica, debido a factores de riesgo propios del grupo etario, como los factores anatómicos y condiciones ambientales (asistencia a guardería, ausencia de lactancia materna y exposición al humo del tabaco, entre otros). El diagnóstico de certeza de la OMA es clínico y se basa en el inicio súbito del padecimiento, signos y síntomas de otitis media y líquido en el oído medio. El método más certero para evaluar la integridad de la membrana timpánica es la otoscopia simple, aunque la variante neumática es la más efectiva para establecer el compromiso en la movilidad de la membrana timpánica.  Para la elección del tratamiento adecuado de la OMA se deben considerar diversos factores, entre ellos la edad del paciente, el estadio clínico, si existen tratamientos previos y el tiempo de evolución. La estrategia &#8220;esperar y ver&#8221; acompañada de analgésicos sistémicos por 48 a 72 horas disminuye la tasa de prescripción innecesaria de antibióticos en los casos de enfermedad no grave. El tratamiento antibiótico de primera línea, en el caso de que no haya mejoría con la primera estrategia o en forma directa es la amoxicilina a dosis de 80-90 mg/kg, y la combinación de amoxicilina con ácido clavulánico es el siguiente escalón cuando hay falla terapéutica con el primero, y una cefalosporina como la ceftriaxona, cuando se ha tenido falla terapéutica con amoxicilina y otro antimicrobiano previo. El tratamiento recomendado en pacientes alérgicos a la penicilina es claritromicina. La incidencia de complicaciones de la OMA es baja, éstas pueden ser: otitis media recurrente, hipoacusia conductiva, mastoiditis, parálisis del nervio facial, meningitis y absceso cerebral. Se recomienda realizar un seguimiento 3 a 6 meses después de un episodio sin complicaciones.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Acute otitis media (AOM) is a highly prevalent disease worldwide, primarily in pediatric patients due to the inherent risk factors in their age group, anatomical and environmental conditions such as day care attendance, lack of breastfeeding and exposure to cigarette smoke, among others. The definitive diagnosis of AOM is clinical and is based on a sudden onset of the disease, signs and symptoms of otitis media and fluid in middle ear.  The most accurate method to evaluate the integrity of the patient&#8217;s tympanic membrane is a simple otoscopy, although its pneumatic variant is the most effective tool to determinate loss of tympanic membrane mobility. Several factors, including the patient's age, clinical stage, previous treatment and time evolution should be considered in order to choose the right treatment for AOM. The "wait-and-see prescription" in addition to systemic analgesics for 48-72 hours reduces unnecessary antibiotic prescription in non-severe cases. Amoxicillin 80-90 mg/kg is the first-line antibiotic in case of no improvement with the first strategy. A combination of amoxicillin and clavulanate is the next step when first antibiotic therapy fails. A cephalosporin like Ceftriaxone is indicated in treatment failure with amoxicillin in addition to other previous antimicrobial. The recommended treatment in patients allergic to penicillin is clarithromycin. The incidence of complications of AOM is low, these include: recurrent otitis media, conductive hearing loss, mastoiditis, facial nerve paralysis, meningitis and brain abscess. Monitoring 3-6 months after an episode without complications is recommended.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Otitis media aguda]]></kwd>
<kwd lng="es"><![CDATA[membrana timpánica]]></kwd>
<kwd lng="es"><![CDATA[cuadro clínico]]></kwd>
<kwd lng="es"><![CDATA[tratamiento]]></kwd>
<kwd lng="en"><![CDATA[Acute otitis media]]></kwd>
<kwd lng="en"><![CDATA[tympanic membrane]]></kwd>
<kwd lng="en"><![CDATA[clinical profile]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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