Garcés-Sánchez M, Díez-Domingo J, Alvarez de Labiada T, Planelles V, Graullera M, Baldo J Ma, García Llop L A, García López M, Peris Vidal A, Gallego García Ma D, Ballester Sanz A, Peidro C, Villarroya J, Jubert A, Colomer Revuelta J, Casani C
Pediatra de Atención Primaria, Instituto de Vacunas de Valencia (VIVA), Spain.
An Pediatr (Barc). 2004 Feb;60(2):125-32. doi: 10.1016/s1695-4033(04)78232-6.
To assess the burden (incidence, treatment and complications) of acute otitis media (AOM) and otitis media with effusion (OME) in children younger than 5 years of age from Valencia, Spain.
We performed a retrospective cohort study of 1,399 children followed-up for the first 5 years of life. Seventeen pediatricians reviewed the medical records of their patients born in 1995 and 1996 and followed-up from birth until the age of 5 years. For each child, the number of otitis episodes, treatment, complications, and surgical interventions was obtained.
There were 2,961 episodes of AOM in the first 5 years of life (2.23 cases/child). Four hundred seventy-six cases (16.1 %) occurred before 1 year of age and 1,346 between the first and second year of life (45.5 %). By the third year of life, 59.8 % had had at least one episode. In most children (80.9 %), diagnosis was made in primary care and required a median of 1.81 visits/episode for follow-up. A total of 94.5 % were treated with antibiotics (amoxicillin-clavulanate 38.8 %, cefuroxime 14.3 %, clarithromycin 8.2 % and amoxicillin 5.9 %) and 8.5 % required a change of antibiotic therapy. Two hundred seventeen children (15.2 %) had at least one episode of OME. Twenty-six patients (1.8 %, 95 % CI: 1.2-2.7 %) required insertion of ventilation tubes. Twenty-four patients (1.7 %) had secondary hypoacusis. There was one case of meningitis and two cases of chronic otorrhea. No cases of mastoiditis were recorded.
The incidence of AOM in Valencia is 40,014 episodes/100,000 children younger than 5 years/year (95 % CI: 39,700-40,300). It represents a significant burden due to the large number of visits, antibiotic use, associated surgical procedures and need for auditory rehabilitation.
评估西班牙巴伦西亚5岁以下儿童急性中耳炎（AOM）和中耳积液（OME）的负担（发病率、治疗及并发症情况）。
我们对1399名儿童进行了一项回顾性队列研究，追踪其生命最初5年的情况。17名儿科医生查阅了他们1995年和1996年出生患者的病历，并从出生一直追踪到5岁。对于每个儿童，获取中耳炎发作次数、治疗情况、并发症及外科手术干预的相关信息。
在生命的前5年中发生了2961次AOM发作（2.23例/儿童）。476例（16.1%）发生在1岁之前，1346例发生在1岁至2岁之间（45.5%）。到3岁时，59.8%的儿童至少发作过一次。在大多数儿童（80.9%）中，诊断在初级保健机构进行，每次发作随访平均需要就诊1.81次。总共94.5%的患儿接受了抗生素治疗（阿莫西林 - 克拉维酸38.8%，头孢呋辛14.3%，克拉霉素8.2%，阿莫西林5.9%），8.5%的患儿需要更换抗生素治疗。217名儿童（15.2%）至少有一次OME发作。26名患者（1.8%，95%CI：1.2 - 2.7%）需要插入通气管。24名患者（1.7%）出现继发性听力减退。有1例脑膜炎和2例慢性耳漏。未记录到乳突炎病例。
巴伦西亚AOM的发病率为40,014次发作/100,000名5岁以下儿童/年（95%CI：39,700 - 40,300）。由于就诊次数多、抗生素使用、相关外科手术以及听觉康复需求，这构成了一项重大负担。
