Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK.
Fam Pract. 2021 Jul 28;38(4):448-453. doi: 10.1093/fampra/cmaa150.
Although primarily considered a childhood disease, acute otitis media (AOM) also occurs in adults. Data on the burden of this condition in adults are, however, scarce.
To explore the primary care incidence and current management of AOM in adults.
All patients aged 15 and older included in the routine health care database of the Julius General Practitioners' Network were followed from 2015 to 2018 (contributing to a total of 1 261 575 person-years). We extracted data on AOM episodes, AOM-related consultations, comorbidities, and antibiotic and analgesic prescriptions.
Five thousand three hundred and fifty-eight patients experienced one or more AOM episodes (total number of AOM episodes: 6667; mean 1.2 per patient). The overall AOM incidence was 5.3/1000 person-years and was fairly stable over the study period. Incidence was particularly high in atopic patients (7.3/1000 person-years) and declined with age (from 7.1 in patients 15-39 years of age to 2.7/1000 person-years in those aged 64 years and older). Oral antibiotics, predominantly amoxicillin, were prescribed in 46%, and topical antibiotics in 21% of all episodes.
Over the past years, the incidence of AOM in adults in primary care has been stable. Oral antibiotic prescription rates resemble those in children with AOM, whereas a remarkably high topical antibiotic prescription rate was observed. Future prognostic research should inform on the need and feasibility of prospective studies into the best management strategy in this condition.
尽管急性中耳炎（AOM）主要被认为是一种儿童疾病，但它也发生在成年人中。然而，关于成年人患这种疾病的负担的数据却很少。
探讨成年人原发性 AOM 的发病率和当前管理情况。
从 2015 年至 2018 年，对 Julius 全科医生网络常规医疗数据库中所有年龄在 15 岁及以上的患者进行了随访（总计 1261575 人年）。我们提取了与 AOM 发作、与 AOM 相关的就诊、合并症以及抗生素和镇痛药处方有关的数据。
5358 名患者经历了一次或多次 AOM 发作（总 AOM 发作数：6667；每位患者平均 1.2 次）。总体 AOM 发病率为 5.3/1000 人年，且在研究期间相对稳定。在特应性患者中发病率较高（7.3/1000 人年），且随年龄增长而下降（从 15-39 岁患者的 7.1/1000 人年降至 64 岁及以上患者的 2.7/1000 人年）。在所有发作中，口服抗生素（主要是阿莫西林）的处方率为 46%，局部抗生素的处方率为 21%。
在过去几年中，成年人原发性 AOM 的发病率在初级保健中保持稳定。口服抗生素的处方率与患有 AOM 的儿童相似，而局部抗生素的处方率却非常高。未来的预后研究应阐明在这种情况下进行前瞻性研究最佳管理策略的必要性和可行性。
Zotero 插件