Year: 2021
Type: conference-abstract
Abstract: Acute otitis media (AOM) is considered to be one of the main causes of bacterial infection in children, being a major cause of admission to the emergency department (ED) and antibiotic prescription. The prescription of antibiotics in AOM should be carefully thought, due to the increased resistance to antimicrobials. A retrospective, descriptive, comparative analysis of a randomized pediatric population (n=1646) admitted to the ED between november 2014 and december 2019 with the diagnosis of AOM was performed. Exclusion criteria included age <28 days, chronic diseases associated with nasopharyngeal colonization by unusual microorganisms, craniofacial malformations or presence of cochlear implants. Clinical and therapeutic information was collected through clinical records. Deferred antibiotic prescription (DAP) was considered if 48 hours of anti-inflammatory therapeutic was advised before initiating antibiotics. Statistical analysis was performed and p<0,05 was considered statistically significative. Amongst all patients, 54,3% were males and in 85,7% it was their first medical observation. The median age, at admission, was 3 years with median time of illness evolution 2 days. Mean age was higher in the group that reported fever (3,00 vs 5,29 years, p<0.01) and conjunctivitis (1,62 vs 4,01 years, P<0.01), unlike in the group with othalgia (5,31 vs 1,94 years; P<0.01) and otorrhea (4,54 vs 3,72 years P<0.01). DAP was the chosen conduct in 6,8% of cases, none of them <6 months. Bilateral otitis was present in 12,3% of cases, 58,6% of which happened <2 years, with recorded DAP of 0.08% in this last group. We registered 2 cases of mastoiditis and 1 fungal infection; none had gone through DAP. Number of illness days (2,38 vs 3,12; p<0.01) and patients age (5,05 vs 3,83; p<0.01) was different between those with DAP vs initial antibiotic prescription. The mean duration of antibiotic treatment in the group <2 years was 7,31 (±1,02) days and in with ≥2 years was 6,83 (±1,4) (p<0,01). Of the 1531 to whom antibiotic was prescript, 270 (17,6%) were medicated with other antibiotic than amoxicillin (excluding cases of amoxicillin allergy, recent amoxicillin, therapeutic failure and conjunctivitis). Amoxicillin was prescribed in 66,8% of cases, followed by amoxicillin/clavunate in 20,8%, which was more prescribed in the population with associated conjunctivitis (30,3%). Our study showed that AOM is a benign infection, with DAP not reveling worst prognosis, as described in literature. However, DAP is still underperformed, being necessary its practical application, as well as the use of first-line antibiotics, supported on current recommendations.
Source: Abstracts
Institution: Centro Hospitalar Tondela-Viseu
Language: English
Topic: Ear Surgery and Otitis Media
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3206852508