Acute Pediatric Mastoiditis: A Single-Center Experience. Pre and Post Pneumococcal Vaccination and “Watchful-Waiting” Era

Background:A suppurative infection of the mastoid air cells, complication of acute otitis media, is defined as acute mastoiditis.With the introduction of pneumoccocal vaccination, the incidence of otitis media in pediatric population has dropped and new treatment guidelines have been introduced, but it remains unclear whether this decrease has been also seen in acute mastoiditis.

Objective:To compare and evaluate the demographics and clinical characteristics ofchildrenwith acute mastoiditisin pre and post pneumoccocal vaccination and “watchful-waiting” era.

Methods:We reviewed retrospectively medical charts of childrenaged 1 month to 16 years admitted at the University Hospital Quirón Dexeus with acute mastoiditis from January 2014 to January 2019 and compared it with a group collected and published in a period from January 1998 to January 2002.

Results:A total of twenty-two cases were collected, 14 (68%) males and 8 (32%) females, with the mean age of 5.4 years and 6 (27.3%) patients younger than 2 years. We found a statistically significant decrease in the incidence, use computerized tomography as a mean on diagnosis, less use of third generation cephalosporins and faster diagnosis compared with the previous group.

Conclusions:After the introduction of pneumococcal vaccination, the incidence of acute mastoiditis in our population has been reduced, but this remains to be proven in larger studies. The more prudent use of antibiotics and the vaccination will prove to be rightful pathway to further reduce this potentially harmful complication.