Tympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland

2.50
Hdl Handle:
http://hdl.handle.net/2336/31272
Title:
Tympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland
Authors:
Arason, Vilhjalmur A; Sigurdsson, Johann A; Kristinsson, Karl G; Gudmundsson, Sigurdur
Citation:
Pediatr. Infect. Dis. J. 2002, 21(12):1110-5
Issue Date:
1-Dec-2002
Abstract:
BACKGROUND: Widespread antimicrobial use is a risk factor for development of antimicrobial resistance. Antimicrobial treatment of acute otitis media (AOM) may not always be necessary. Little is known about the influence of parental expectations on physicians' decision-making in relation to treatment of AOM. Evidence is insufficient as to whether tympanostomy tube placement reduces antibiotic consumption. METHODS: We randomly selected 1,030 children 1 to 6 years old living in 4 geographic areas in Iceland to be invited to participate in the study. Information about sociodemographic factors, antimicrobial prescriptions and their indications during the preceding 12 months, tympanostomy tube placements and parental views on antimicrobial use and bacterial resistance were obtained from a questionnaire completed by the parents and medical records. RESULTS: The incidence of AOM episodes resulting in antimicrobial prescription for 804 children recruited into the study was 0.7 (95% confidence interval, 0.6 to 0.8) per child per year, highest among children age 1 year, i.e. 1.8 prescriptions (95% confidence interval, 1.4 to 2.2). The cumulative incidence of tympanostomy tube placements was approximately 30%. Antimicrobial use during the preceding 8 weeks for children with and without tubes did not differ (P = 0.36). Fifteen percent of children with tubes had received antimicrobials during the preceding 8 weeks at last once for AOM compared with 14% of those without tubes (P = 0.97). Parents in the area where antimicrobial consumption was lowest were less likely to accept antimicrobial treatment than parents in the other areas (P = 0.005). Parents of children who had previously received antimicrobials for AOM were more likely to accept antimicrobials (P = 0.04). CONCLUSIONS: Parental expectations to antimicrobial treatment and awareness about resistance development appear to influence treatment strategies for AOM. The high rate of tympanostomy tube placement in preschool children does not result in reduced antimicrobial consumption.
Description:
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Additional Links:
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Full metadata record

DC FieldValue Language
dc.contributor.authorArason, Vilhjalmur A-
dc.contributor.authorSigurdsson, Johann A-
dc.contributor.authorKristinsson, Karl G-
dc.contributor.authorGudmundsson, Sigurdur-
dc.date.accessioned2008-07-08T11:04:32Z-
dc.date.available2008-07-08T11:04:32Z-
dc.date.issued2002-12-01-
dc.date.submitted2008-07-06-
dc.identifier.citationPediatr. Infect. Dis. J. 2002, 21(12):1110-5en
dc.identifier.issn0891-3668-
dc.identifier.pmid12488659-
dc.identifier.doi10.1097/01.inf.0000040702.00373.95-
dc.identifier.urihttp://hdl.handle.net/2336/31272-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Widespread antimicrobial use is a risk factor for development of antimicrobial resistance. Antimicrobial treatment of acute otitis media (AOM) may not always be necessary. Little is known about the influence of parental expectations on physicians' decision-making in relation to treatment of AOM. Evidence is insufficient as to whether tympanostomy tube placement reduces antibiotic consumption. METHODS: We randomly selected 1,030 children 1 to 6 years old living in 4 geographic areas in Iceland to be invited to participate in the study. Information about sociodemographic factors, antimicrobial prescriptions and their indications during the preceding 12 months, tympanostomy tube placements and parental views on antimicrobial use and bacterial resistance were obtained from a questionnaire completed by the parents and medical records. RESULTS: The incidence of AOM episodes resulting in antimicrobial prescription for 804 children recruited into the study was 0.7 (95% confidence interval, 0.6 to 0.8) per child per year, highest among children age 1 year, i.e. 1.8 prescriptions (95% confidence interval, 1.4 to 2.2). The cumulative incidence of tympanostomy tube placements was approximately 30%. Antimicrobial use during the preceding 8 weeks for children with and without tubes did not differ (P = 0.36). Fifteen percent of children with tubes had received antimicrobials during the preceding 8 weeks at last once for AOM compared with 14% of those without tubes (P = 0.97). Parents in the area where antimicrobial consumption was lowest were less likely to accept antimicrobial treatment than parents in the other areas (P = 0.005). Parents of children who had previously received antimicrobials for AOM were more likely to accept antimicrobials (P = 0.04). CONCLUSIONS: Parental expectations to antimicrobial treatment and awareness about resistance development appear to influence treatment strategies for AOM. The high rate of tympanostomy tube placement in preschool children does not result in reduced antimicrobial consumption.en
dc.language.isoenen
dc.publisherWilliams & Wilkinsen
dc.relation.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00006454-200212000-00005&LSLINK=80&D=ovften
dc.subject.meshAcute Diseaseen
dc.subject.meshAdulten
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshConfidence Intervalsen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshMaleen
dc.subject.meshMiddle Ear Ventilationen
dc.subject.meshOdds Ratioen
dc.subject.meshOtitis Media with Effusionen
dc.subject.meshParentsen
dc.subject.meshPatient Satisfactionen
dc.subject.meshProbabilityen
dc.subject.meshQuestionnairesen
dc.subject.meshRisk Assessmenten
dc.subject.meshSampling Studiesen
dc.subject.meshSeverity of Illness Indexen
dc.subject.meshSocioeconomic Factorsen
dc.subject.meshTreatment Outcomeen
dc.titleTympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Icelanden
dc.typeArticleen
dc.contributor.departmentDepartment of Family Medicine, Univeristy of Iceland, Solvangur, Hafnarfjordur, Iceland. vaa@hgsolvangur.isen
dc.identifier.journalPediatric infectious disease journalen

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