急性中耳炎药物处方模式：对意大利儿科医生和耳鼻喉科医生的一项调查

Patterns in acute otitis media drug prescriptions: a survey of Italian pediatricians and otolaryngologists.

作者信息

Marchisio Paola, Tagliabue Marta, Klersy Catherine, Mira Eugenio, Pagella Fabio, Baggi Elena, Fattizzo Miriam, Esposito Susanna, Principi Nicola

机构信息

Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

出版信息

Expert Rev Anti Infect Ther. 2014 Sep;12(9):1159-63. doi: 10.1586/14787210.2014.944503. Epub 2014 Jul 30.

DOI:10.1586/14787210.2014.944503

PMID:25075863

Abstract

OBJECTIVE

To evaluate whether physicians follow current guidelines for managing acute otitis media (AOM) and whether educational programs are needed to improve knowledge of AOM treatment among paediatricians (PEDs) and otolaryngologists (ENTs) Methods: A total of 1270 PEDs and 852 ENTs were randomly selected and interviewed with an anonymous questionnaire about how they managed AOM.

RESULTS

Inappropriate AOM approaches were identified among 60.2% of PEDs and 88.5% of ENTs (p < 0.001). Amoxicillin and amoxicillin with clavulanic acid were appropriately chosen as first-line drugs by the majority of PEDs and ENTs, although significantly more ENTs reported otherwise (15.8% PEDs vs 25.5% ENTs; p < 0.001). ENTs were significantly more likely than PEDs to report prescribing decongestants, mucolytics, anti-inflammatory drugs, and steroids (p < 0.001).

CONCLUSION

These results show that AOM prescriptions for antibiotics and adjunctive treatments are often inappropriate and highlight the need for educational strategies aimed at PEDs and ENTs to improve their compliance with evidence-based guidelines for AOM treatment.

摘要

目的

评估医生是否遵循当前急性中耳炎（AOM）的管理指南，以及是否需要开展教育项目以提高儿科医生（PEDs）和耳鼻喉科医生（ENTs）对AOM治疗的认识。方法：随机选取1270名儿科医生和852名耳鼻喉科医生，通过匿名问卷询问他们对AOM的处理方式。

结果

60.2%的儿科医生和88.5%的耳鼻喉科医生存在不恰当的AOM处理方法（p<0.001）。大多数儿科医生和耳鼻喉科医生将阿莫西林和阿莫西林克拉维酸合理地选为一线药物，不过报告选择其他药物的耳鼻喉科医生显著更多（儿科医生为15.8%，耳鼻喉科医生为25.5%；p<0.001）。耳鼻喉科医生比儿科医生更有可能报告开具减充血剂、黏液溶解剂、抗炎药和类固醇（p<0.001）。