Otitis media across nine countries: disease burden and management.
OBJECTIVE
To assess the perceived disease burden and management of otitis media (OM) among an international cohort of experienced physicians.


METHODS
A cross-sectional survey conducted in France, Germany, Spain, Poland, Argentina, Mexico, South Korea, Thailand and Saudi Arabia. Face-to-face interviews conducted with 1800 physicians (95% paediatricians, 5% family practitioners).Main outcome measures were the perceived burden on clinical practice (number of cases, complications and referrals) and first- and second-line management strategies for OM. Results are expressed as mean and range across the nine countries over three continents.


RESULTS
Respondents estimated an average annual caseload of 375 (range 128-1003) children under 5 years of age with OM; 54% (range 44-71%) with an initial episode and 38% (range 27-54%) with recurrent OM (ROM). OM with complications was estimated to be approximately 20 (range 7-49) cases per year and an estimated 15% (8-41%) of children with OM was recalled as needing specialist referral. There was high awareness of Streptococcus pneumoniae and Haemophilus influenzae as causative bacterial pathogens: 77% (range 65-91%) and 74% (range 68-83%), respectively, but less recognition of non-typeable H. influenzae (NTHi); 59% (range 45-67%). Although concern over antimicrobial resistance was widespread, empirical treatment with antibiotics was the most common first-line treatment (mean 81%, range 40-96%). The burden of disease is substantial enough that many physicians would consider vaccination to prevent OM (mean score 5.1, range 4.3-6.2 on 1-7 scale).


CONCLUSIONS
This large, multinational survey shows that OM remains a significant burden for clinical practice. Despite awareness of shortcomings, antimicrobial therapy remains the most frequent treatment for OM.
Arguedas
A
A
Instituto de Atención Pediátrica and Universidad de Ciencias Médicas, PO Box 607-1150 La Uruca, San José, Costa Rica. aarguedas@iped.net
Kvaerner
K
K
Liese
J
J
Schilder
A G M
AG
Pelton
S I
SI
D001118:Argentina / Q000453:epidemiology; D002675:Child, Preschool; D003625:Data Collection; D005194:Family Practice; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D010033:Otitis Media / Q000453:epidemiology / Q000628:therapy*; D010372:Pediatrics; D011044:Poland / Q000453:epidemiology; D056910:Republic of Korea / Q000453:epidemiology; D012529:Saudi Arabia / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology