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Prescription of antibiotics to children with acute otitis media in Danish general practice

BACKGROUND: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s o...

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Autores principales: Olsen, Jonas K., Lykkegaard, Jesper, Hansen, Malene Plejdrup, Waldorff, Frans B., Lous, Jørgen, Andersen, Merethe K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457240/
https://www.ncbi.nlm.nih.gov/pubmed/32854621
http://dx.doi.org/10.1186/s12875-020-01248-0
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author Olsen, Jonas K.
Lykkegaard, Jesper
Hansen, Malene Plejdrup
Waldorff, Frans B.
Lous, Jørgen
Andersen, Merethe K.
author_facet Olsen, Jonas K.
Lykkegaard, Jesper
Hansen, Malene Plejdrup
Waldorff, Frans B.
Lous, Jørgen
Andersen, Merethe K.
author_sort Olsen, Jonas K.
collection PubMed
description BACKGROUND: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s objective was to analyse associations between patient- and general practitioner (GP) characteristics and antibiotic prescribing for children with AOM in an effort to explain the high antibiotic prescribing rates. METHODS: All general practices in the Northern, Southern and Central regions of Denmark were invited to record symptoms, examinations, findings and antibiotic treatment for all children ≤7 years of age diagnosed with AOM during a four-week winter period in 2017/2018. Associations were analysed by means of multivariate logistic regressions. The study design was cross-sectional. RESULTS: GPs from 60 general practices diagnosed 278 children with AOM of whom 207 (74%) were prescribed antibiotics, most often penicillin V (60%). About half of the children had tympanometry performed. Antibiotic prescribing rates varied considerably between practices (0–100%). Antibiotic prescribing was associated with fever (odds ratio (OR) 3.69 95% confidence interval (CI) 1.93–7.05), purulent ear secretion (OR 2.35 95% CI 1.01–5.50) and poor general condition (OR 3.12 95% CI 1.31–7.46), and the practice’s antibiotic prescribing rate to other patients with symptoms of an acute respiratory tract infection (OR 2.85 CI 95% 1.07–7.60) and specifically to other children with AOM (OR 4.15 CI 95% 1.82–9.47). CONCLUSION: GPs’ antibiotic prescribing rates for children with AOM vary considerably even considering the of signs, symptoms, request for antibiotics, and use of tympanometry. Interventions to reduce overprescribing should be targeted high-prescribing practices.
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spelling pubmed-74572402020-08-31 Prescription of antibiotics to children with acute otitis media in Danish general practice Olsen, Jonas K. Lykkegaard, Jesper Hansen, Malene Plejdrup Waldorff, Frans B. Lous, Jørgen Andersen, Merethe K. BMC Fam Pract Research Article BACKGROUND: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s objective was to analyse associations between patient- and general practitioner (GP) characteristics and antibiotic prescribing for children with AOM in an effort to explain the high antibiotic prescribing rates. METHODS: All general practices in the Northern, Southern and Central regions of Denmark were invited to record symptoms, examinations, findings and antibiotic treatment for all children ≤7 years of age diagnosed with AOM during a four-week winter period in 2017/2018. Associations were analysed by means of multivariate logistic regressions. The study design was cross-sectional. RESULTS: GPs from 60 general practices diagnosed 278 children with AOM of whom 207 (74%) were prescribed antibiotics, most often penicillin V (60%). About half of the children had tympanometry performed. Antibiotic prescribing rates varied considerably between practices (0–100%). Antibiotic prescribing was associated with fever (odds ratio (OR) 3.69 95% confidence interval (CI) 1.93–7.05), purulent ear secretion (OR 2.35 95% CI 1.01–5.50) and poor general condition (OR 3.12 95% CI 1.31–7.46), and the practice’s antibiotic prescribing rate to other patients with symptoms of an acute respiratory tract infection (OR 2.85 CI 95% 1.07–7.60) and specifically to other children with AOM (OR 4.15 CI 95% 1.82–9.47). CONCLUSION: GPs’ antibiotic prescribing rates for children with AOM vary considerably even considering the of signs, symptoms, request for antibiotics, and use of tympanometry. Interventions to reduce overprescribing should be targeted high-prescribing practices. BioMed Central 2020-08-27 /pmc/articles/PMC7457240/ /pubmed/32854621 http://dx.doi.org/10.1186/s12875-020-01248-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Olsen, Jonas K.
Lykkegaard, Jesper
Hansen, Malene Plejdrup
Waldorff, Frans B.
Lous, Jørgen
Andersen, Merethe K.
Prescription of antibiotics to children with acute otitis media in Danish general practice
title Prescription of antibiotics to children with acute otitis media in Danish general practice
title_full Prescription of antibiotics to children with acute otitis media in Danish general practice
title_fullStr Prescription of antibiotics to children with acute otitis media in Danish general practice
title_full_unstemmed Prescription of antibiotics to children with acute otitis media in Danish general practice
title_short Prescription of antibiotics to children with acute otitis media in Danish general practice
title_sort prescription of antibiotics to children with acute otitis media in danish general practice
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457240/
https://www.ncbi.nlm.nih.gov/pubmed/32854621
http://dx.doi.org/10.1186/s12875-020-01248-0
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