Tags

Type your tag names separated by a space and hit enter

Tympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland.
Pediatr Infect Dis J 2002; 21(12):1110-5PI

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.

Authors+Show Affiliations

Department of Family Medicine, Univeristy of Iceland, Solvangur, Hafnarfjordur, Iceland. vaa@hgsolvangur.is

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12488659

Citation

Arason, Vilhjalmur A., et al. "Tympanostomy Tube Placements, Sociodemographic Factors and Parental Expectations for Management of Acute Otitis Media in Iceland." The Pediatric Infectious Disease Journal, vol. 21, no. 12, 2002, pp. 1110-5.
Arason VA, Sigurdsson JA, Kristinsson KG, et al. Tympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland. Pediatr Infect Dis J. 2002;21(12):1110-5.
Arason, V. A., Sigurdsson, J. A., Kristinsson, K. G., & Gudmundsson, S. (2002). Tympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland. The Pediatric Infectious Disease Journal, 21(12), pp. 1110-5.
Arason VA, et al. Tympanostomy Tube Placements, Sociodemographic Factors and Parental Expectations for Management of Acute Otitis Media in Iceland. Pediatr Infect Dis J. 2002;21(12):1110-5. PubMed PMID: 12488659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tympanostomy tube placements, sociodemographic factors and parental expectations for management of acute otitis media in Iceland. AU - Arason,Vilhjalmur A, AU - Sigurdsson,Johann A, AU - Kristinsson,Karl G, AU - Gudmundsson,Sigurdur, PY - 2002/12/19/pubmed PY - 2003/1/31/medline PY - 2002/12/19/entrez SP - 1110 EP - 5 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 21 IS - 12 N2 - 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. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/12488659/Tympanostomy_tube_placements_sociodemographic_factors_and_parental_expectations_for_management_of_acute_otitis_media_in_Iceland_ L2 - http://Insights.ovid.com/pubmed?pmid=12488659 DB - PRIME DP - Unbound Medicine ER -