scholarly journals Reducing antibiotic use in children with acute otitis media

BMJ ◽  
1999 ◽  
Vol 319 (7202) ◽  
pp. 124-124
Author(s):  
R W Clarke ◽  
C. Cates
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mina Park ◽  
Jiyeon Han ◽  
Jiwon Park ◽  
Myoung-jin Jang ◽  
Moo Kyun Park

AbstractParticulate matter (PM) is the main component of air pollution. Children are vulnerable to PM and acute otitis media (AOM), which is one of the most common diseases in children. However, studies on the relationship between AOM in children and PM are rare and their results are inconsistent. The aim of this study is to investigate the effect of PM on AOM in children on the basis of the Korea National Health Insurance service (NHIS) claims data. NHIS claim data from 2008 to 2015 was used to identify outpatient visits, antibiotic use to treat AOM, and demographic data. This data was combined with the data on PM2.5 (≤ 2.5 μm) and PM10 (≤ 10 μm according to its aerodynamic diameter) level extracted from air pollution data from Korean National Institute of Environmental Research for 16 administrative regions. The children with AOM were divided into three age groups (< 2, 2–4, 5–10 years). Generalized linear Poisson regression model was used to estimate the association between AOM and PM using daily counts of AOM and daily mean PM concentrations. It was adjusted to temperature, wind, humidity, season, year, age, and region. With an increase in PM2.5 of 10 μg/m3, the relative risk of OM increased by 4.5% in children under 2 years of age. The effect of PM2.5 was strongest influence on the day of exposure. The exposure to PM10 was related to the incidence of AOM on the day of exposure and the following seven days in all three age groups. The PM concentrations did not strongly affect either AOM duration or the use of antibiotics to cure AOM. The RR in the each lag day after exposure to PM10 was diverse according to the age groups. Regardless of PM size and children’s age, the PM levels are positively related to the incidence of AOM. Both PM2.5 and PM10 have the most adverse effects on children under 2 years of age and on the day of exposure.


CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S38-S39
Author(s):  
A. Dobrin ◽  
S. Belisle ◽  
S. Ali ◽  
S. Brahmbatt ◽  
K. Kumar ◽  
...  

Introduction: In children, acute otitis media (AOM) pain is undertreated. We sought to determine if video discharge instructions were associated with improved symptomatology, functional outcomes, and knowledge compared to a paper handout. Methods: We conducted a randomized controlled superiority trial comparing video discharge instructions (Easy Sketch Pro3TM) on management of pain to a paper handout detailing the same. We included caregivers of children 6 months to 5 years presenting to the emergency department (ED) with a clinical diagnosis of AOM. The primary outcome was symptomatology using the Acute Otitis Media Severity of Symptom (AOM SOS) score between 48 and 72 hours. The 7-item self-report AOM-SOS is scored from 0 to 13 with a higher score indicating more symptomatology. Secondary outcomes included knowledge gain using a 10-item survey, days of daycare/school/work missed, and recidivism. Assuming a minimal clinically important AOM-SOS difference of 2, 90% power, and 5% alpha, 60 individuals/group was needed. Results: 219 caregivers were randomized and 149 completed the 72-hour follow-up (72 paper and 77 video). The median (IQR) AOM-SOS score in the video group (adjusted for pre-intervention AOM-SOS, analgesic and antibiotic use) was significantly lower than paper [8 (7,11) versus 10 (7,13), respectively, p=0.004]. There were no significant differences between video and paper in the mean (SD) knowledge score [9.2 (1.3) versus 8.8 (1.8) correct answers, respectively, p=0.07], mean (SD) number that returned to a health provider [8/77 versus 10/72, respectively, p=0.49), mean (SD) number of daycare/schooldays missed [1.2 (1.5) versus 1.1 (2.1), respectively, p=0.62], and mean (SD) number of workdays missed by caregiver [0.5 (1) versus 0.8 (2), respectively, p=0.05]. Conclusion: Video discharge instructions are associated with less symptomatology compared to a paper handout, are effective for caregiver education in the ED, and should be used routinely.


2012 ◽  
Vol 78 (17) ◽  
pp. 6262-6270 ◽  
Author(s):  
Melinda M. Pettigrew ◽  
Alison S. Laufer ◽  
Janneane F. Gent ◽  
Yong Kong ◽  
Kristopher P. Fennie ◽  
...  

ABSTRACTThe composition of the upper respiratory tract microbial community may influence the risk for colonization by the acute otitis media (AOM) pathogensStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalis. We used culture-independent methods to describe upper respiratory tract microbial communities in healthy children and children with upper respiratory tract infection with and without concurrent AOM. Nasal swabs and data were collected in a cross-sectional study of 240 children between 6 months and 3 years of age. Swabs were cultured forS. pneumoniae, and real-time PCR was used to identifyS. pneumoniae,H. influenzae, andM. catarrhalis. The V1-V2 16S rRNA gene regions were sequenced using 454 pyrosequencing. Microbial communities were described using a taxon-based approach. Colonization byS. pneumoniae,H. influenzae, andM. catarrhaliswas associated with lower levels of diversity in upper respiratory tract flora. We identified commensal taxa that were negatively associated with colonization by each AOM bacterial pathogen and with AOM. The balance of these relationships differed according to the colonizing AOM pathogen and history of antibiotic use. Children with antibiotic use in the past 6 months and a greater abundance of taxa, includingLactococcusandPropionibacterium, were less likely to have AOM than healthy children (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.25 to 0.85). Children with no antibiotic use in the past 6 months, a low abundance ofStreptococcusandHaemophilus, and a high abundance ofCorynebacteriumandDolosigranulumwere less likely to have AOM (OR, 0.51; 95% CI, 0.31 to 0.83). An increased understanding of polymicrobial interactions will facilitate the development of effective AOM prevention strategies.


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