The variability and appropriateness of the antibiotic prescription of acute otitis media in childhood. The Spanish Study Group for Antibiotic Treatments.
OBJECTIVE
To know the variability of treatment of acute otitis media in Spain and the appropriateness of such with respect to consensus.


METHODS
A descriptive, multicentre, prospective study was carried out in the services of 11 Spanish hospitals. Children diagnosed with acute otitis media and treated on 30 days selected randomly between January and June 1997 were included. An analysis of treatment variability was made. The results were compared with consensus conference of a panel of experts.


RESULTS
Out of the 29436 emergencies studied on 30 days, 821 were diagnosed with acute otitis media. Fifteen point seven percent of the cases were already receiving antibiotics (22% amoxicillin clavulanate, 20% amoxicillin and 11% cefuroxime axetil). For the treatment, at discharge, of the 93% an antibiotic was prescribed (amoxicillin clavulanate in 41%, amoxicillin in 15%, cefuroxime axetil in 11%, cefaclor 6% and azithromycin 5%). Two point eight percent of the children were admitted. According to the guidelines of the panel of experts consulted, appropriateness was 61% for antibiotics of first choice, 12% for drugs of alternate use and 25% for inadequate treatment. The different hospitals presented significant variability in the type of antibiotic used and the appropriateness of such.


CONCLUSIONS
Acute otitis media is treated with antibiotics in 93% of the cases diagnosed in Spanish hospitals. The most commonly used antibiotics are amoxicillin clavulanate and amoxicillin alone. The prescription and its appropriateness present significant variability in the different hospitals studied.
Solís
G
G
Departament of Pediatrics, Hospital de Cabueñes, Gijón, Spain. gsolis@las.es
Ochoa
C
C
Pérez Méndez
C
C
D000208:Acute Disease; D000658:Amoxicillin / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002444:Cefuroxime / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010033:Otitis Media / Q000188:drug therapy*; D010406:Penicillins / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D002444:Cefuroxime; C040738:cefuroxime axetil