Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Journal of Paediatrics and Child Health
Niroshan BalasundaramGerben Keijzers

Abstract

To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines. We performed a retrospective descriptive cohort study of patients ≤15 years of age who presented to two EDs in Southeast Queensland between January 2016 and June 2017 with an ED diagnosis of AOM. Likelihood of diagnosis was based on medical records and classified as likely, possible or unlikely using paediatric practice guidelines. Appropriateness of antibiotics prescription was classified using the National Antibiotic Prescribing Survey, which takes into account adherence to the Australian Therapeutic Guidelines. Each medical record was extracted by two blinded reviewers, and discrepancies were resolved by consensus or arbitration. Of the 305 patients included for analysis, 87% had a likely or possible diagnosis of AOM. Otalgia was the presenting complaint in 75%. Standard otoscopy was the routine method for tympanic membrane visualisation, and 70% had abnormal tympanic membrane findings. Almost two-thirds (62%) of all children were prescribed antibiotics. Antibiotic appropriateness could be ascertained for 286 patients (94%). ...Continue Reading

References

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May 4, 2004·Pediatrics·UNKNOWN American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media
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Mar 5, 2016·Paediatrics & Child Health·Nicole Le SauxUNKNOWN Canadian Paediatric Society, Infectious Diseases and Immunization Committee
Dec 22, 2016·The New England Journal of Medicine·Alejandro HobermanNader Shaikh

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Citations

Jul 5, 2019·Expert Opinion on Investigational Drugs·Nicola Principi, Susanna Esposito
Feb 3, 2020·International Journal of Pediatric Otorhinolaryngology·Regie Lyn P Santos-CortezGarth D Ehrlich
Oct 9, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Nanako Shirai, Diego Preciado

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