title: Adherence to acute otitis media treatment guidelines among primary health care providers in Israel.
abstract: OBJECTIVE
  To determine the appropriateness of the acute otitis media antibiotic treatment prescribed in the community in relation to the therapeutic guidelines.
  
  
  METHODS
  Children aged 3 months-3 years diagnosed with simple uncomplicated acute otitis media in 6 community primary care clinics were enrolled. Data on the antibiotic treatment were collected using computerized medical files.
  
  
  RESULTS
  689 simple uncomplicated acute otitis media patients were enrolled; 597 (86.9%) were treated with antibiotics by 38 family medicine practitioners, 12 pediatricians and 7 general practitioners. 461 (77.2%) patients were <2 years of age. Amoxicillin was administered to 540 (90.5%) patients, with no differences between the various medical specialties. 127/540 (23.5%) patients did not receive the appropriate dosage; 140/413 (33.9%) patients treated with appropriate dosage did not receive the treatment for the appropriate duration of time. 258/357 (72.3%) evaluable patients <2 years of age received an antibiotic considered inappropriate to guidelines (38 not treated with amoxicillin, 94 received inappropriate dosage and 126 not treated for 10 days); 53/100 (53%) evaluable children >2 years of age received an inappropriate antibiotic treatment.
  
  
  CONCLUSIONS
  The majority of primary care physicians treat simple uncomplicated acute otitis media with the recommended antibiotic drug. However, incorrect dosage and shorter than recommended duration of therapy may jeopardize the quality of care in children with simple uncomplicated acute otitis media.
authors.affiliation: Division of Pediatrics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Noa
authors.initials: N
authors.lastname: Shviro-Roseman
authors.affiliation: Division of Pediatrics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Reuveni
authors.affiliation: Division of Pediatrics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Gazala
authors.affiliation: Division of Pediatrics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: eugenel@bgu.ac.il.
authors.forename: Eugene
authors.initials: E
authors.lastname: Leibovitz
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007557:Israel; D010033:Otitis Media / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute otitis media; Antibiotics; Community; Physicians