American Academy of Pediatrics and American Academy of Family Physicians
Pediatrics. 2013 Mar;131(3):e964-99. doi: 10.1542/peds.2012-3488. Epub 2013 Feb 25.
This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM. In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships. The practice guideline underwent comprehensive peer review before formal approval by the AAP. This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem.
本循证临床实践指南是对美国儿科学会（AAP）和美国家庭医生学会 2004 年急性中耳炎（AOM）指南的修订。它为初级保健临床医生提供了 6 个月至 12 岁儿童单纯性 AOM 管理的建议。2009 年，AAP 召集了一个由初级保健医生和儿科、家庭医学、耳鼻喉科、流行病学、传染病、急诊医学和指南方法学领域专家组成的委员会。该小组委员会与医疗保健研究与质量局和南加州循证实践中心合作，对自 2000 年初始证据报告以来与 AOM 相关的新文献进行了全面审查。由此产生的证据报告和其他数据来源被用于制定实践指南建议。本实践指南的重点是对出现 AOM 的儿童进行适当的诊断和初始治疗。该指南对 AOM 进行了明确、严格的定义。它涉及疼痛管理、初始观察与抗生素治疗、抗生素药物的适当选择以及预防措施。它还涉及到未包含在 2004 年指南中的复发性 AOM。决策是基于对证据质量和利弊关系的系统分级。该实践指南在获得 AAP 正式批准之前，经过了全面的同行评审。本临床实践指南并非儿童 AOM 管理的唯一指导来源。相反，它旨在通过提供临床决策框架来帮助初级保健临床医生。它不是为了替代临床判断或为所有患有这种疾病的儿童制定方案。这些建议可能不是解决这个问题的唯一合适方法。
