G. Solis et al., The variability and appropriateness of the antibiotic prescription of acute otitis media in childhood, INT J PED O, 56(3), 2000, pp. 175-184
Citations number
28
Categorie Soggetti
Otolaryngology
Journal title
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY
Objective: To know the variability of treatment of acute otitis media in Sp
ain and the appropriateness of such with respect to consensus. Material and
methods: A descriptive, multicentre, prospective study was carried out in
the services of 11 Spanish hospitals. Children diagnosed with acute otitis
media and treated on 30 days selected randomly between January and June 199
7 were included. An analysis of treatment variability was made. The results
were compared with consensus conference of a panel of experts. Results: Ou
t of the 29 436 emergencies studied on 30 days, 821 were diagnosed with acu
te otitis media. Fifteen point seven percent of the cases were already rece
iving antibiotics (22% amoxicillin clavulanate, 20% amoxicillin and 11% cef
uroxime axetil). For the treatment, at discharge, of the 93% an antibiotic
was prescribed (amoxicillin clavulanate in 41%, amoxicillin in 15%, cefurox
ime axetil in 11%, cefaclor 6% and azithromycin 5%). Two point eight percen
t of the children were admitted. According to the guidelines of the panel o
f experts consulted, appropriateness was 61% for antibiotics of first choic
e, 12% for drugs of alternate use and 25% for inadequate treatment. The dif
ferent hospitals presented significant variability in the type of antibioti
c used and the appropriateness of such. Conclusions: Acute otitis media is
treated with antibiotics in 93% of the cases diagnosed in Spanish hospitals
. The most commonly used antibiotics are amoxicillin clavulanate and amoxic
illin alone. The prescription and its appropriateness present significant v
ariability in the different hospitals studied. (C) 2000 Elsevier Science Ir
eland Ltd. All rights reserved.