Assessing diagnostic accuracy and tympanocentesis
skills by nurse practitioners in management of otitis media.
studies show that if not treated, or if treated with an incorrect antibiotic, the bacteria are still there at least four days later.
In the antibiotic-treated group, the tympanocentesis
site was not found in any animal on day 7.
In studies conducted prior to 2000, diagnostic tympanocentesis
isolated S pneumoniae from 25% to 55% of all middle ear aspirates from children with AOM.
is the recommended procedure for collecting specimens that will yield reliable microbiological results to guide therapy in otitis media.
The results demonstrated serious disagreements among respondents: 14 percent thought tympanocentesis
(puncturing of the ear drum) posed minimal risk or less, 46 percent classified this as a minor increment over minimal risk, and 40 percent thought it more than a minor increase.
Setting or Location for the Exercise of Surgical or Invasive Procedure Privileges; Monitoring Procedures Performed that Require Specific Privileges; Cross-Department Privileges by procedure (ECG interpretation, Swan-Ganz catheter insertion, vasectomy, sigmoidoscopy, hyperbaric oxygen therapy, amniocentesis, thoracotomy tube insertion and management, tympanocentesis
, C-sections, endoscopies);
Also, she said, the 2017 data regarding AOM pathogens are from a single-site tympanocentesis
study, and although the data in the past have represented national trends, caution should be used when generalizing from one study.
AOM episodes diagnosed by a pediatrician and AOM-related procedures, such as tympanocentesis
, adenectomy, transtympanic aerator tube insertion were recorded during a 12-month follow-up period.
persistent fever) after 48-72 hours of appropriate, compliant initial antibiotic therapy, consider referral to an otorhinolaryngologist for tympanocentesis
and MEF culture.
The University of Rochester Institutional Review Board approved the study, and written informed consent was obtained from parents or guardians for the study and for all tympanocentesis
The prospective study included 212 Children from the authors' clinic who underwent tympanocentesis
for acute otitis media (AOM) during one of three respiratory seasons: September 2003-June 2004, September 2004-June 2005, and September 2005-June 2006.
Saeed et al compared the value of otoscopy, tympanometry, and tympanocentesis
in detecting AOM, with and without effusion, in 90 children/They found that tympanocentesis
did not detect middle ear effusion in 14% of the cases in which it had been detected by the other two methods.
In choosing preferred agents, the CDC gave primary consideration to pharmacokinetic/pharmacodynamic data and to clinical efficacy trials that used tympanocentesis
results (especially double tympanocentesis
) as evidence of diagnosis and bacteriologic outcome.
Treatment failure on day 3 would then require IM ceftriaxone, clindamycin, or tympanocentesis