P3.Q325: Evidence Based Treatment of Otitis Media Utilizing Osteopathic Manipulative Medicine in Pediatrics

Background: Otitis media (OM) is the second most common pediatric diagnosis in emergency rooms, with over 20 million pediatric primary care visits annually. Nearly 90% of children experience acute otitis media (AOM) by age 2, often leading to recurrent cases before age 5. Traditional treatments involve antibiotics, yet antibiotic resistance drives exploration of non-pharmacological therapies. Osteopathic manipulative treatment (OMT) emerges as a holistic approach, with studies indicating its potential to hasten AOM resolution and alleviate symptoms. However, evidence on OMT's safety and cost-effectiveness in AOM management remains sparse, warranting further investigation.

Methods: The primary aim of this narrative review serves to synthesizes evidence on OMT responses in pediatric AOM cases, drawing from multiple databases including CINAHL, Embase, PubMed, Google Scholar, and Clinical Key. The search strategy employed specific keywords related to AOM, OMT, and pediatric populations to ensure comprehensive coverage. The secondary aim serves to standardize an OMT protocol to be utilized by physicians and caregivers outlining techniques to treat AOM in children.

Results: A total of 21 articles were reviewed, with four selected to reflect current standards in AOM treatment with OMT highlighted in Table 1. Key studies, including randomized controlled trials by Steele et al. and Mills et al., demonstrated significant improvements in AOM resolution rates with OMT alongside standard care compared to standard care alone. These findings underscore the potential of OMT as an effective adjunctive therapy in managing pediatric AOM.

Conclusion: AOM is prevalent in children under 5, highlighting the importance of effective management strategies. This review underscores the beneficial role of OMT as an adjunctive therapy, supported by clear correlations in symptom reduction and infection frequency. To facilitate its integration into clinical practice, a standardized OMT protocol has been developed, presented as a trifold brochure for physicians and caregivers. Future validation studies will assess its efficacy for home use, aligning with OMT's holistic approach and addressing antibiotic resistance concerns in AOM management. The evidence supports the integration of OMT into pediatric AOM management, offering a promising adjunctive therapy to standard care. The study team plans to assess the safety and cost-effectiveness to enhance its adoption, potentially reducing reliance on antibiotics and improving outcomes for young patients. Continued collaboration between researchers, clinicians, and caregivers is essential to advance the evidence base and optimize the use of OMT in pediatric AOM treatment.