Patterns in acute otitis media drug prescriptions: a survey of Italian pediatricians and otolaryngologists

Objective: To evaluate whether physicians follow current guidelines for managing acute otitis media (AOM) and whether educational programs are needed to improve knowledge of AOM treatment among paediatricians (PEDs) and otolaryngologists (ENTs) Methods: A total of 1270 PEDs and 852 ENTs were randomly selected and interviewed with an anonymous questionnaire about how they managed AOM. Results: Inappropriate AOM approaches were identified among 60.2% of PEDs and 88.5% of ENTs (p < 0.001). Amoxicillin and amoxicillin with clavulanic acid were appropriately chosen as first-line drugs by the majority of PEDs and ENTs, although significantly more ENTs reported otherwise (15.8% PEDs vs 25.5% ENTs; p < 0.001). ENTs were significantly more likely than PEDs to report prescribing decongestants, mucolytics, anti-inflammatory drugs, and steroids (p < 0.001). Conclusion: These results show that AOM prescriptions for antibiotics and adjunctive treatments are often inappropriate and highlight the need for educational strategies aimed at PEDs and ENTs to improve their compliance with evidence-based guidelines for AOM treatment.

[1]  R. Duncan,et al.  Diagnosis and Management of Acute Otitis Media , 2019, Jurnal Penelitian Perawat Profesional.

[2]  Haruo Takahashi,et al.  Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan - 2013 update. , 2015, Auris, nasus, larynx.

[3]  John P Birchall,et al.  Update on otitis media – prevention and treatment , 2014, Infection and drug resistance.

[4]  C. Nesbit,et al.  An evidence-based approach to managing acute otitis media. , 2013, Pediatric emergency medicine practice.

[5]  R. Rosenfeld,et al.  The diagnosis and management of acute otitis media. , 2013, Pediatrics.

[6]  A. Mugelli,et al.  Update of the 2009 Italian Pediatric Society Guidelines about management of fever in children. , 2012, Clinical therapeutics.

[7]  Liang-Yu Lin,et al.  Physicians are not adherent to clinical practice guidelines for acute otitis media. , 2011, International journal of pediatric otorhinolaryngology.

[8]  A. Speciale,et al.  Acute otitis media: From diagnosis to prevention. Summary of the Italian guideline. , 2010, International journal of pediatric otorhinolaryngology.

[9]  L. Vernacchio,et al.  Management of Acute Otitis Media After Publication of the 2004 AAP and AAFP Clinical Practice Guideline , 2010, Pediatrics.

[10]  Carlos G. Grijalva,et al.  Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings. , 2009, JAMA.

[11]  C. Klersy,et al.  Medical Education and Attitudes About Acute Otitis Media Guidelines: A Survey of Italian Pediatricians and Otolaryngologists , 2009, The Pediatric infectious disease journal.

[12]  G. Scadding,et al.  Nasal saline irrigations for the symptoms of chronic rhinosinusitis. , 2008, The Cochrane database of systematic reviews.

[13]  A. French Management of Acute Otitis Media by Primary Care Physicians: Trends Since the Release of the 2004 American Academy of Pediatrics/American Academy of Family Physicians Clinical Practice Guideline , 2007 .

[14]  A. Mitchell,et al.  Management of Acute Otitis Media by Primary Care Physicians: Trends Since the Release of the 2004 American Academy of Pediatrics/American Academy of Family Physicians Clinical Practice Guideline , 2007, Pediatrics.

[15]  A. Mitchell,et al.  Knowledge and Practices Relating to the 2004 Acute Otitis Media Clinical Practice Guideline: A Survey of Practicing Physicians , 2006, The Pediatric infectious disease journal.

[16]  D. Greenberg,et al.  Adherence to therapeutic guidelines for acute otitis media in children younger than 2 years. , 2006, International journal of pediatric otorhinolaryngology.

[17]  D. Poetker,et al.  Disease severity in patients referred to pediatric otolaryngologists with a diagnosis of otitis media. , 2006, International journal of pediatric otorhinolaryngology.

[18]  V. Preedy,et al.  Scottish Intercollegiate Guidelines Network , 2010 .

[19]  R. Linsk,et al.  Diagnosis and Management of Acute Otitis Media in Michigan , 2004, Clinical pediatrics.

[20]  T. Heikkinen,et al.  A randomized, placebo-controlled trial of the effect of antihistamine or corticosteroid treatment in acute otitis media. , 2003, The Journal of pediatrics.

[21]  Michael Stewart,et al.  Practice Patterns versus Practice Guidelines in Pediatric Otitis Media , 2001, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[22]  R. Rosenfeld,et al.  Otitis media , 1994, The Lancet.

[23]  R. Goldman,et al.  Antihistamines for children with otitis media. , 2014, Canadian family physician Medecin de famille canadien.

[24]  K. Nishizaki,et al.  Guidelines for acute otitis media in children , 2014 .

[25]  Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan. , 2012, Auris, nasus, larynx.

[26]  I. Brook,et al.  Otitis media. , 2012, Future microbiology.

[27]  Diagnosis and management of childhood otitis media in primary care , 2003 .

[28]  T. Heikkinen,et al.  [Recommended treatment of acute otitis]. , 1999, Duodecim; laaketieteellinen aikakauskirja.

[29]  A. Bitnun,et al.  Medical therapy of otitis media: use, abuse, efficacy, and morbidity. , 1998, The Journal of otolaryngology.