Akute Otitis media

Immunisation with pneumococcal conjugate vaccine (PCV) protects children from invasive as well as localised infections such as acute otitis media (AOM). During the pivotal prelicensure study of the seven-valent PCV (PCV-7), efficacy against vaccine-serotype AOM was 67% and against any form of AOM was 9%. Recently, the indication of AOM has been granted for PCV-7 in the European Union. Since pneumococcal immunisation was introduced in the United States for children less than 2 years of age, further data have accumulated regarding PCV-7 efficiency against AOM. In one representative study, the overall frequency of AOM in the ambulatory setting declined by 20% in the target age group shortly after the program began. Some investigations indicate the possibility of replacement disease by other pneumococcal serotypes and other bacteria not covered by the vaccine. Further careful investigations are needed to recognise such epidemiological changes.