INTRODUCTION: Otitis media (OM) is a common problem in primary care and constitutes a significant health burden in <5-year-olds. Middle-ear effusion after acute OM is also a common problem that causes hearing loss in a substantial proportion of children and is a frequent reason why primary care providers refer children to specialists. However, there are limited non-US data on pediatricians' awareness and attitudes toward OM disease burden, complications, and causative pathogens.
OBJECTIVE: A multinational survey was undertaken to validate and measure primary care physicians' attitudes and behaviors toward OM.
METHODS: Two thousand pediatricians from 10 countries (4 European, 3 Asian, 2 Latin American, and 1 Middle Eastern) were interviewed. Questions focused on the number of children younger than 5 who were treated for OM in the previous year, perceptions about complications and sequelae, awareness of OM pathogens, and concerns about current disease-management practice.
RESULTS: Reported estimates of OM in <5-year-olds was 349 (range: 125–1000) cases per year per practice (ie, pediatricians treated at least 1 patient with OM per day). Eighty-two percent of the pediatricians reported that they treat OM with first-line antibiotics; they were generally satisfied but viewed antibiotic resistance as a serious issue. Nineteen percent of children were referred to an ear, nose, and throat specialist because of treatment failure, recurrent/chronic OM, or hearing problems or for surgery. Pediatricians associated OM with 2 main pathogens: Streptococcus pneumoniae (77%) and Haemophilus influenzae (73%). Association of nontypeable H influenzae was significantly lower (40%).
CONCLUSIONS: OM is frequently treated by pediatricians in daily practice. A majority of them seem to use antibiotics as first-line treatment. The most common reasons for specialist referrals include treatment failures, recurrent/chronic OM, hearing problems, and surgery. Hearing loss and antibiotic resistance are of concern. Nontypeable H influenzae is less well known as an otopathogen.
- Copyright © 2008 by the American Academy of Pediatrics