Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms

Eduardo Jorge da Fonseca Lima; Fernanda Zeilmann Cazzetta; Maria Eduarda de Araújo Cabral; Caroline Cordeiro de Andrade; Pedro Jorge Serra da Fonseca Lima; Patrícia Gomes de Matos Bezerra

doi:doi:10.11648/j.ajp.20190503.13

Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms

Eduardo Jorge da Fonseca Lima, Fernanda Zeilmann Cazzetta, Maria Eduarda de Araújo Cabral, Caroline Cordeiro de Andrade, Pedro Jorge Serra da Fonseca Lima, Patrícia Gomes de Matos Bezerra

Published in American Journal of Pediatrics (Volume 5, Issue 3)

Received: 22 May 2019 Accepted: 24 June 2019 Published: 4 July 2019

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Abstract

Background: AOM is characterized by its high prevalence and morbidity but low lethality. It is estimated that 70% of children will have had one episode prior to completing five years of age Compliance with the guidelines for acute otitis media (AOM) may avoid complications. This study aimed at determining whether pediatricians follow the guidelines for AOM management. Methods: A prospective, cross-sectional study involving pediatricians working in emergency centers in Recife. A specific questionnaire was used to collect data. Results: Of the 71 pediatrics interviewed around 98% gave importance to crying/irritability and otalgia when diagnosing otitis and all recognized the significance of otorrhoea. All the professionals gave importance to bulging tympanic membrane, 98.6% to acute tympanic membrane perforation, 97.1% to purulent effusion and 46.5% to bilateral hyperemia of the tympanic membrane. Regarding antibiotic therapy, 70.4% used standard doses of amoxicillin as first-line treatment (81.7% prescribing for 10 days). Furthermore only 47.9% double the dose in case of therapeutic failure. Conclusion: Pediatricians working in emergency departments need to be better informed about the guidelines to decrease inappropriate prescription of antibiotics for AOM. We believe that adoption of the “wait and see” strategy, even in emergency rooms, would be an important means of reducing the inadequate prescription of antibiotics in cases of AOM, thus contributing towards reducing bacterial resistance.

Published in	American Journal of Pediatrics (Volume 5, Issue 3)
DOI	10.11648/j.ajp.20190503.13
Page(s)	91-97
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Acute Otitis Media, Paediatrics, Guidelines, Diagnosis, Treatment

References

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APA Style

Eduardo Jorge da Fonseca Lima, Fernanda Zeilmann Cazzetta, Maria Eduarda de Araújo Cabral, Caroline Cordeiro de Andrade, Pedro Jorge Serra da Fonseca Lima, et al. (2019). Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms. American Journal of Pediatrics, 5(3), 91-97. https://doi.org/10.11648/j.ajp.20190503.13

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ACS Style

Eduardo Jorge da Fonseca Lima; Fernanda Zeilmann Cazzetta; Maria Eduarda de Araújo Cabral; Caroline Cordeiro de Andrade; Pedro Jorge Serra da Fonseca Lima, et al. Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms. Am. J. Pediatr. 2019, 5(3), 91-97. doi: 10.11648/j.ajp.20190503.13

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AMA Style

Eduardo Jorge da Fonseca Lima, Fernanda Zeilmann Cazzetta, Maria Eduarda de Araújo Cabral, Caroline Cordeiro de Andrade, Pedro Jorge Serra da Fonseca Lima, et al. Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms. Am J Pediatr. 2019;5(3):91-97. doi: 10.11648/j.ajp.20190503.13

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@article{10.11648/j.ajp.20190503.13,
  author = {Eduardo Jorge da Fonseca Lima and Fernanda Zeilmann Cazzetta and Maria Eduarda de Araújo Cabral and Caroline Cordeiro de Andrade and Pedro Jorge Serra da Fonseca Lima and Patrícia Gomes de Matos Bezerra},
  title = {Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {3},
  pages = {91-97},
  doi = {10.11648/j.ajp.20190503.13},
  url = {https://doi.org/10.11648/j.ajp.20190503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190503.13},
  abstract = {Background: AOM is characterized by its high prevalence and morbidity but low lethality. It is estimated that 70% of children will have had one episode prior to completing five years of age Compliance with the guidelines for acute otitis media (AOM) may avoid complications. This study aimed at determining whether pediatricians follow the guidelines for AOM management. Methods: A prospective, cross-sectional study involving pediatricians working in emergency centers in Recife. A specific questionnaire was used to collect data. Results: Of the 71 pediatrics interviewed around 98% gave importance to crying/irritability and otalgia when diagnosing otitis and all recognized the significance of otorrhoea. All the professionals gave importance to bulging tympanic membrane, 98.6% to acute tympanic membrane perforation, 97.1% to purulent effusion and 46.5% to bilateral hyperemia of the tympanic membrane. Regarding antibiotic therapy, 70.4% used standard doses of amoxicillin as first-line treatment (81.7% prescribing for 10 days). Furthermore only 47.9% double the dose in case of therapeutic failure. Conclusion: Pediatricians working in emergency departments need to be better informed about the guidelines to decrease inappropriate prescription of antibiotics for AOM. We believe that adoption of the “wait and see” strategy, even in emergency rooms, would be an important means of reducing the inadequate prescription of antibiotics in cases of AOM, thus contributing towards reducing bacterial resistance.},
 year = {2019}
}

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TY  - JOUR
T1  - Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms
AU  - Eduardo Jorge da Fonseca Lima
AU  - Fernanda Zeilmann Cazzetta
AU  - Maria Eduarda de Araújo Cabral
AU  - Caroline Cordeiro de Andrade
AU  - Pedro Jorge Serra da Fonseca Lima
AU  - Patrícia Gomes de Matos Bezerra
Y1  - 2019/07/04
PY  - 2019
N1  - https://doi.org/10.11648/j.ajp.20190503.13
DO  - 10.11648/j.ajp.20190503.13
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 91
EP  - 97
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20190503.13
AB  - Background: AOM is characterized by its high prevalence and morbidity but low lethality. It is estimated that 70% of children will have had one episode prior to completing five years of age Compliance with the guidelines for acute otitis media (AOM) may avoid complications. This study aimed at determining whether pediatricians follow the guidelines for AOM management. Methods: A prospective, cross-sectional study involving pediatricians working in emergency centers in Recife. A specific questionnaire was used to collect data. Results: Of the 71 pediatrics interviewed around 98% gave importance to crying/irritability and otalgia when diagnosing otitis and all recognized the significance of otorrhoea. All the professionals gave importance to bulging tympanic membrane, 98.6% to acute tympanic membrane perforation, 97.1% to purulent effusion and 46.5% to bilateral hyperemia of the tympanic membrane. Regarding antibiotic therapy, 70.4% used standard doses of amoxicillin as first-line treatment (81.7% prescribing for 10 days). Furthermore only 47.9% double the dose in case of therapeutic failure. Conclusion: Pediatricians working in emergency departments need to be better informed about the guidelines to decrease inappropriate prescription of antibiotics for AOM. We believe that adoption of the “wait and see” strategy, even in emergency rooms, would be an important means of reducing the inadequate prescription of antibiotics in cases of AOM, thus contributing towards reducing bacterial resistance.
VL  - 5
IS  - 3
ER  -

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Author Information

Eduardo Jorge da Fonseca Lima

Departament of the Lato Sensu Postgraduate Course of Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) and Department of Graduation of Faculdade Pernambucana de Saúde (FPS), Recife, Brazil
Fernanda Zeilmann Cazzetta

Department of Graduation of Faculdade, Pernambucana de Saúde (FPS), Recife, Brazil
Maria Eduarda de Araújo Cabral

Department of Graduation of Faculdade, Pernambucana de Saúde (FPS), Recife, Brazil
Caroline Cordeiro de Andrade

Department of Graduation of Faculdade, Pernambucana de Saúde (FPS), Recife, Brazil
Pedro Jorge Serra da Fonseca Lima

Department of Graduation of Faculdade, Pernambucana de Saúde (FPS), Recife, Brazil
Patrícia Gomes de Matos Bezerra

Departament of Pediatric Pulmonology of Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) and Department of Graduation of Faculdade Pernambucana de Saúde (FPS), Recife, Brazil

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APA Style

Eduardo Jorge da Fonseca Lima, Fernanda Zeilmann Cazzetta, Maria Eduarda de Araújo Cabral, Caroline Cordeiro de Andrade, Pedro Jorge Serra da Fonseca Lima, et al. (2019). Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms. American Journal of Pediatrics, 5(3), 91-97. https://doi.org/10.11648/j.ajp.20190503.13

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ACS Style

Eduardo Jorge da Fonseca Lima; Fernanda Zeilmann Cazzetta; Maria Eduarda de Araújo Cabral; Caroline Cordeiro de Andrade; Pedro Jorge Serra da Fonseca Lima, et al. Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms. Am. J. Pediatr. 2019, 5(3), 91-97. doi: 10.11648/j.ajp.20190503.13

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AMA Style

Eduardo Jorge da Fonseca Lima, Fernanda Zeilmann Cazzetta, Maria Eduarda de Araújo Cabral, Caroline Cordeiro de Andrade, Pedro Jorge Serra da Fonseca Lima, et al. Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms. Am J Pediatr. 2019;5(3):91-97. doi: 10.11648/j.ajp.20190503.13

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@article{10.11648/j.ajp.20190503.13,
  author = {Eduardo Jorge da Fonseca Lima and Fernanda Zeilmann Cazzetta and Maria Eduarda de Araújo Cabral and Caroline Cordeiro de Andrade and Pedro Jorge Serra da Fonseca Lima and Patrícia Gomes de Matos Bezerra},
  title = {Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {3},
  pages = {91-97},
  doi = {10.11648/j.ajp.20190503.13},
  url = {https://doi.org/10.11648/j.ajp.20190503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190503.13},
  abstract = {Background: AOM is characterized by its high prevalence and morbidity but low lethality. It is estimated that 70% of children will have had one episode prior to completing five years of age Compliance with the guidelines for acute otitis media (AOM) may avoid complications. This study aimed at determining whether pediatricians follow the guidelines for AOM management. Methods: A prospective, cross-sectional study involving pediatricians working in emergency centers in Recife. A specific questionnaire was used to collect data. Results: Of the 71 pediatrics interviewed around 98% gave importance to crying/irritability and otalgia when diagnosing otitis and all recognized the significance of otorrhoea. All the professionals gave importance to bulging tympanic membrane, 98.6% to acute tympanic membrane perforation, 97.1% to purulent effusion and 46.5% to bilateral hyperemia of the tympanic membrane. Regarding antibiotic therapy, 70.4% used standard doses of amoxicillin as first-line treatment (81.7% prescribing for 10 days). Furthermore only 47.9% double the dose in case of therapeutic failure. Conclusion: Pediatricians working in emergency departments need to be better informed about the guidelines to decrease inappropriate prescription of antibiotics for AOM. We believe that adoption of the “wait and see” strategy, even in emergency rooms, would be an important means of reducing the inadequate prescription of antibiotics in cases of AOM, thus contributing towards reducing bacterial resistance.},
 year = {2019}
}

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TY  - JOUR
T1  - Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms
AU  - Eduardo Jorge da Fonseca Lima
AU  - Fernanda Zeilmann Cazzetta
AU  - Maria Eduarda de Araújo Cabral
AU  - Caroline Cordeiro de Andrade
AU  - Pedro Jorge Serra da Fonseca Lima
AU  - Patrícia Gomes de Matos Bezerra
Y1  - 2019/07/04
PY  - 2019
N1  - https://doi.org/10.11648/j.ajp.20190503.13
DO  - 10.11648/j.ajp.20190503.13
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 91
EP  - 97
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20190503.13
AB  - Background: AOM is characterized by its high prevalence and morbidity but low lethality. It is estimated that 70% of children will have had one episode prior to completing five years of age Compliance with the guidelines for acute otitis media (AOM) may avoid complications. This study aimed at determining whether pediatricians follow the guidelines for AOM management. Methods: A prospective, cross-sectional study involving pediatricians working in emergency centers in Recife. A specific questionnaire was used to collect data. Results: Of the 71 pediatrics interviewed around 98% gave importance to crying/irritability and otalgia when diagnosing otitis and all recognized the significance of otorrhoea. All the professionals gave importance to bulging tympanic membrane, 98.6% to acute tympanic membrane perforation, 97.1% to purulent effusion and 46.5% to bilateral hyperemia of the tympanic membrane. Regarding antibiotic therapy, 70.4% used standard doses of amoxicillin as first-line treatment (81.7% prescribing for 10 days). Furthermore only 47.9% double the dose in case of therapeutic failure. Conclusion: Pediatricians working in emergency departments need to be better informed about the guidelines to decrease inappropriate prescription of antibiotics for AOM. We believe that adoption of the “wait and see” strategy, even in emergency rooms, would be an important means of reducing the inadequate prescription of antibiotics in cases of AOM, thus contributing towards reducing bacterial resistance.
VL  - 5
IS  - 3
ER  -

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