Volume 5, Issue 3, September 2019, Page: 91-97
Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms
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
Received: May 22, 2019;       Accepted: Jun. 24, 2019;       Published: Jul. 4, 2019
DOI: 10.11648/j.ajp.20190503.13      View  112      Downloads  41
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.
Keywords
Acute Otitis Media, Paediatrics, Guidelines, Diagnosis, Treatment
To cite this article
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, Acute Otitis Media in Childhood - Use of Guidelines for Diagnosis and Treatment in Emergency Rooms, American Journal of Pediatrics. Vol. 5, No. 3, 2019, pp. 91-97. doi: 10.11648/j.ajp.20190503.13
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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