「小児急性中耳炎診療ガイドライン」の検討 Treatment outcome of acute otitis media in children treated with the newly released guideline in Japan
Treatment outcome of acute otitis media (AOM) in children was assessed when treated with the newlyreleased clinical guideline in Japan. Our goal of this study is to clarify how appropriate this guideline is andwhether it has any difficulties in use for daily clinical practice. Twelve hospitals in Hokkaido, Japan participatedin this study between May and September 2006. Patients were diagnosed and treated according to the guideline. Swab samples were obtained from nasopharynx at their first visits to detect pathogens. Patients wererequested to visit the clinic 3 days, a week, 2 weeks, and 4 weeks after their first visit.<BR>A hundred forty-six patients'records were analyzed on the initial stages, initial scores of the tympanicmembranes (TMs), isolated bacteria, and treatment information including antibiotics and myringotomy theyunderwent. Twenty-five patients dropped out of the study, therefore 121 patients were followed until their TMscores reached zero. A hundred ninety-eight bacteria were isolated from 133 patients. Fifty-seven percent of <I>S. pneumoniae</I> were penicillin resistant and 59% of<I> H. influenzae</I> were β-lactamase non-producing ampicillin resistantstrains. A hundred twenty-two of 146 patients (84%) underwent antibiotic therapy recommended in the guideline.Sixty-three of 76 recommended cases (83%) underwent myringotomy. Eleven cases (9%) still hadinflammatory changes in their TMs even a week after their first visit. However, 8 of these 11 cases achievedTM score 0 in 2 weeks, and so did the others in 4 weeks after their first visit. Moreover, their symptom scoresreached zero in a week for all patients.<BR>Improvement of symptoms and TM findings was satisfactory when patients with AOM in children weretreated with the guideline. This guideline would be expected to play an important role to spread the appropriateuse of antibiotics in this country.
- Otology Japan
Otology Japan 17(2), 118-123, 2007-05-25
THE JAPAN OTOLOGICAL SOCIETY