A randomized clinical trial to assess the effects of tympanometry on the diagnosis and treatment of acute otitis media

Pediatrics
David M SpiroSteven Baldwin

Abstract

Acute otitis media (OM) is the most common indication for the use of antibiotics among children. Otoscopy alone is an imprecise method for the diagnosis of OM, which may lead to inappropriate antibiotic use. We sought to determine whether tympanometry, as an adjunct to otoscopy, would significantly change physician prescribing behavior and whether physicians overprescribe antibiotics for OM, using independently graded tympanometry results as a standard. A randomized, clinical trial was conducted among children 6 to 35 months of age who presented to a pediatric emergency department with either fever or upper respiratory infection symptoms. Children were randomized into 2 groups, in which the attending physician evaluated tympanometry results (Tymp Aware) or the attending physician was blinded to the tympanometry findings (Tymp Unaware). Tympanometry curves were graded independently by using a modified version of the Jerger scale. Of the 698 patients enrolled, tympanometry was performed successfully for 99.3%. Antibiotics were prescribed for OM for 27.9% of all patients. No statistically significant difference in antibiotic prescription rates for OM between the Tymp Aware group (28.8%) and the Tymp Unaware group (26.8%) was found...Continue Reading

References

Sep 1, 1992·International Journal of Pediatric Otorhinolaryngology·T FinitzoO Brown
Apr 1, 1973·The Laryngoscope·C D BluestoneJ L Paradise
Oct 1, 1970·Archives of Otolaryngology·J Jerger
May 1, 1980·The Annals of Otology, Rhinology & Laryngology. Supplement·E I CantekinD L Sabo
Nov 7, 1996·The New England Journal of Medicine·H S Gold, R C Moellering
Aug 1, 1997·Clinical Otolaryngology and Allied Sciences·G W WattersA P Freeland
Sep 25, 1997·JAMA : the Journal of the American Medical Association·B SchwartzJ M Hughes
Apr 18, 2000·Archives of Pediatrics & Adolescent Medicine·J A FinkelsteinR Platt
Aug 10, 2000·Family Practice·E C JohansenE W Eriksen
Jun 19, 2002·JAMA : the Journal of the American Medical Association·Linda F McCaigJames M Hughes
Aug 26, 2003·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M E Pichichero

❮ Previous
Next ❯

Citations

Jul 20, 2012·The Journal of Laryngology and Otology·Edward C Toll, Desmond A Nunez
May 4, 2012·BMC Gastroenterology·Mostafa Abdel-Aziz El-HodhodAlhag Ahmed Mohamed Ramadan
Jun 21, 2014·International Journal of Pediatric Otorhinolaryngology·Marie Gisselsson-Solen
Feb 24, 2011·Expert Review of Anti-infective Therapy·David M SpiroGarth D Meckler
Apr 26, 2006·Expert Opinion on Emerging Drugs·Avner AliphasKenneth M Grundfast
Aug 21, 2013·Primary Care·Hobart LeeVan Nguyen
Aug 1, 2012·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Gualtiero LeoCristoforo Incorvaia
Aug 24, 2013·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Matteo GelardiNicola Principi
Mar 26, 2014·The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases·Noa Shviro-RosemanEugene Leibovitz
Dec 27, 2019·The Pediatric Infectious Disease Journal·Elena ChiappiniUNKNOWN and the Italian Panel for the Management of Acute Otitis Media in Children
Oct 24, 2018·Frontiers in Pediatrics·Elles M F van de VoortRianne Oostenbrink
May 14, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Alisha PrasadManas Ranjan Gartia

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.