Distribution and Incidence

Surveys of large pediatric populations demonstrate that 80 percent of all children will experience one or more episodes of AOM by the age of 6. Together AOM, OME, and CSOM comprise one of the most common disease entities affecting human populations. Indeed, AOM is thought to be the most common disease treated with antibiotics.

Prevalence studies have demonstrated an extraordinarily high incidence of complicated infections of the middle ear in African, American Indian, Alaskan and Canadian Eskimo, Australian aboriginal, and New Zealand Maori pediatric populations, suggesting that disease-manifesting tissue destruction of the middle-ear and mastoid structures is much more prevalent in these areas. By contrast, studies of children in different geographic areas indicate that the incidence of uncomplicated disease in the middle ear is similar in all areas.

The incidence of complicated infections producing mastoiditis has dramatically declined since the advent of antibiotics in the 1930s and 1940s. Prior to that time, acute coalescent mastoiditis complicated AOM in approximately 20 percent of the cases. Initially, antibiotics cut into mortality rates from mastoiditis, but overall moribidity remained unchanged. By the 1950s, however, the incidence of acute mastoiditis resulting from AOM had declined to 3 percent. Current reports indicate that mastoiditis and other infectious complications will develop in less than 0.5 percent of cases of AOM.

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