[Mastoiditis in children in Iceland].
BACKGROUND
Mastoiditis is an infection in the mastoid process and is a complication of otitis media. Studies have revealed that the incidence might be increasing with altered antibiotic usage. The aim of the current study was to describe the epidemiology, clinical symptoms and treatment of mastoiditis in Iceland during the last two decades with special emphasis on children and to study possible correlations between antibiotic use and incidence of mastoiditis.


METHODS
Information on patients diagnosed with mastoiditis during the period 1984-2002 at The Children's Hospital Iceland, The Department of Paediatrics, Landakoti and Landspitali--University Hospital Iceland was gathered and clinical data were recorded from patients records of children diagnosed with mastoiditis during 1999-2002. Information on antibiotic use during the years 1989-2002 was obtained from the Ministry of Health in Iceland.


RESULTS
Eighty-four patients were diagnosed with mastoiditis during the period 1984-2002. Of those, 52 (62%) were children less than 18 years of age. The mean age of those children was 2 years and 8 months. Boys were 58%. Twenty six (50%) of the children were less than three years old. During the years 1999-2002, a total of 28 children were diagnosed; the mean age was 2 years and 2 months. Fifteen children (54%) sought medical attention within a week prior to admission to hospital and had been diagnosed with otitis media. Eleven children (73%) were appropriately treated with antibiotics prior to the diagnosis of mastoiditis but four (27%) received no antibiotics. During the period 1989-2002, a statistically significant correlation was detected between decreased antibiotic use among children and increasing incidence of mastoiditis (r=-0.68; p=0.007).


CONCLUSIONS
Following changes in guidelines for antibiotic prescriptions for otitis media in Iceland during the nineties, antibiotic use in children decreased at the same time as the incidence for mastoiditis increased. It is uncertain, however, if a causal relationship exists. It is important to diagnose and appropriately treat otitis media, while staying alert for serious complications, especially in young children.
Finnbogadóttir
Anna Freyja
AF
Laeknalid Háskóla Islands.
Petersen
Hannes
H
Laxdal
Thörstur
T
Gudbrandsson
Fridrik
F
Gudnason
Thórólfur
T
Haraldsson
Asgeir
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008417:Mastoiditis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D008499:Medical Records; D010033:Otitis Media / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents