Treatment of acute otitis media in general practice: quality variations across countries

Malene Plejdrup Hansen, Dorte Ejg Jarbol, Bente Gahrn-Hansen, Rene Depont Christensen, Anders Munck, Christina Ellegaard Trankjær Ryborg, Lars Bjerrum

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12 Citations (Scopus)

Abstract

BACKGROUND: Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged <2 years or if AOM is accompanied by discharging ear.

OBJECTIVES: To investigate the quality of treatment of AOM in general practice and to explore the influence of selected GP and patient characteristics on antibiotic prescribing.

METHODS: During the winter 2008, a prospective registration of patients diagnosed with AOM was conducted in general practice in Lithuania, Kaliningrad, Spain, Argentina, Sweden and Denmark. Some 1175 patients diagnosed with AOM were registered. Information about age and sex of the patient, duration of symptoms (days), temperature >38.5°C, ear discharge and the antibiotic treatment given was recorded.

RESULTS: Danish GPs had the lowest antibiotic prescription rate for AOM [72.7% (95% confidence interval (CI) = 67.0-77.8)] and GPs in Kaliningrad had the highest [97.1% (95% CI = 89.8-99.6)]. Narrow-spectrum penicillin was almost exclusively prescribed in the two Nordic countries, while broad-spectrum penicillins, often in combination with clavulanic acid, were prescribed in the other four countries. Macrolides comprised 5-10% of prescriptions. Antibiotic prescribing was associated with the following characteristics of the patients: symptoms for >3 days, ear discharge and fever.

CONCLUSION: The majority of patients with AOM were treated with antibiotics in all six countries, but considerable variations in both prescribing rate and choice of antibiotics were identified.

Original languageEnglish
Pages (from-to)63-68
Number of pages6
JournalFamily Practice
Volume29
Issue number1
DOIs
Publication statusPublished - Feb 2012
Externally publishedYes

Fingerprint

Otitis Media
General Practice
Anti-Bacterial Agents
Penicillins
Therapeutics
Prescriptions
Ear
Confidence Intervals
Scandinavian and Nordic Countries
Clavulanic Acid
Macrolides
Fever
Observation

Cite this

Hansen, M. P., Jarbol, D. E., Gahrn-Hansen, B., Depont Christensen, R., Munck, A., Ellegaard Trankjær Ryborg, C., & Bjerrum, L. (2012). Treatment of acute otitis media in general practice: quality variations across countries. Family Practice, 29(1), 63-68. https://doi.org/10.1093/fampra/cmr042
Hansen, Malene Plejdrup ; Jarbol, Dorte Ejg ; Gahrn-Hansen, Bente ; Depont Christensen, Rene ; Munck, Anders ; Ellegaard Trankjær Ryborg, Christina ; Bjerrum, Lars. / Treatment of acute otitis media in general practice : quality variations across countries. In: Family Practice. 2012 ; Vol. 29, No. 1. pp. 63-68.
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abstract = "BACKGROUND: Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged <2 years or if AOM is accompanied by discharging ear.OBJECTIVES: To investigate the quality of treatment of AOM in general practice and to explore the influence of selected GP and patient characteristics on antibiotic prescribing.METHODS: During the winter 2008, a prospective registration of patients diagnosed with AOM was conducted in general practice in Lithuania, Kaliningrad, Spain, Argentina, Sweden and Denmark. Some 1175 patients diagnosed with AOM were registered. Information about age and sex of the patient, duration of symptoms (days), temperature >38.5°C, ear discharge and the antibiotic treatment given was recorded.RESULTS: Danish GPs had the lowest antibiotic prescription rate for AOM [72.7{\%} (95{\%} confidence interval (CI) = 67.0-77.8)] and GPs in Kaliningrad had the highest [97.1{\%} (95{\%} CI = 89.8-99.6)]. Narrow-spectrum penicillin was almost exclusively prescribed in the two Nordic countries, while broad-spectrum penicillins, often in combination with clavulanic acid, were prescribed in the other four countries. Macrolides comprised 5-10{\%} of prescriptions. Antibiotic prescribing was associated with the following characteristics of the patients: symptoms for >3 days, ear discharge and fever.CONCLUSION: The majority of patients with AOM were treated with antibiotics in all six countries, but considerable variations in both prescribing rate and choice of antibiotics were identified.",
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Hansen, MP, Jarbol, DE, Gahrn-Hansen, B, Depont Christensen, R, Munck, A, Ellegaard Trankjær Ryborg, C & Bjerrum, L 2012, 'Treatment of acute otitis media in general practice: quality variations across countries' Family Practice, vol. 29, no. 1, pp. 63-68. https://doi.org/10.1093/fampra/cmr042

Treatment of acute otitis media in general practice : quality variations across countries. / Hansen, Malene Plejdrup; Jarbol, Dorte Ejg; Gahrn-Hansen, Bente; Depont Christensen, Rene; Munck, Anders; Ellegaard Trankjær Ryborg, Christina; Bjerrum, Lars.

In: Family Practice, Vol. 29, No. 1, 02.2012, p. 63-68.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Treatment of acute otitis media in general practice

T2 - quality variations across countries

AU - Hansen, Malene Plejdrup

AU - Jarbol, Dorte Ejg

AU - Gahrn-Hansen, Bente

AU - Depont Christensen, Rene

AU - Munck, Anders

AU - Ellegaard Trankjær Ryborg, Christina

AU - Bjerrum, Lars

PY - 2012/2

Y1 - 2012/2

N2 - BACKGROUND: Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged <2 years or if AOM is accompanied by discharging ear.OBJECTIVES: To investigate the quality of treatment of AOM in general practice and to explore the influence of selected GP and patient characteristics on antibiotic prescribing.METHODS: During the winter 2008, a prospective registration of patients diagnosed with AOM was conducted in general practice in Lithuania, Kaliningrad, Spain, Argentina, Sweden and Denmark. Some 1175 patients diagnosed with AOM were registered. Information about age and sex of the patient, duration of symptoms (days), temperature >38.5°C, ear discharge and the antibiotic treatment given was recorded.RESULTS: Danish GPs had the lowest antibiotic prescription rate for AOM [72.7% (95% confidence interval (CI) = 67.0-77.8)] and GPs in Kaliningrad had the highest [97.1% (95% CI = 89.8-99.6)]. Narrow-spectrum penicillin was almost exclusively prescribed in the two Nordic countries, while broad-spectrum penicillins, often in combination with clavulanic acid, were prescribed in the other four countries. Macrolides comprised 5-10% of prescriptions. Antibiotic prescribing was associated with the following characteristics of the patients: symptoms for >3 days, ear discharge and fever.CONCLUSION: The majority of patients with AOM were treated with antibiotics in all six countries, but considerable variations in both prescribing rate and choice of antibiotics were identified.

AB - BACKGROUND: Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged <2 years or if AOM is accompanied by discharging ear.OBJECTIVES: To investigate the quality of treatment of AOM in general practice and to explore the influence of selected GP and patient characteristics on antibiotic prescribing.METHODS: During the winter 2008, a prospective registration of patients diagnosed with AOM was conducted in general practice in Lithuania, Kaliningrad, Spain, Argentina, Sweden and Denmark. Some 1175 patients diagnosed with AOM were registered. Information about age and sex of the patient, duration of symptoms (days), temperature >38.5°C, ear discharge and the antibiotic treatment given was recorded.RESULTS: Danish GPs had the lowest antibiotic prescription rate for AOM [72.7% (95% confidence interval (CI) = 67.0-77.8)] and GPs in Kaliningrad had the highest [97.1% (95% CI = 89.8-99.6)]. Narrow-spectrum penicillin was almost exclusively prescribed in the two Nordic countries, while broad-spectrum penicillins, often in combination with clavulanic acid, were prescribed in the other four countries. Macrolides comprised 5-10% of prescriptions. Antibiotic prescribing was associated with the following characteristics of the patients: symptoms for >3 days, ear discharge and fever.CONCLUSION: The majority of patients with AOM were treated with antibiotics in all six countries, but considerable variations in both prescribing rate and choice of antibiotics were identified.

U2 - 10.1093/fampra/cmr042

DO - 10.1093/fampra/cmr042

M3 - Article

VL - 29

SP - 63

EP - 68

JO - Family Practice

JF - Family Practice

SN - 0263-2136

IS - 1

ER -

Hansen MP, Jarbol DE, Gahrn-Hansen B, Depont Christensen R, Munck A, Ellegaard Trankjær Ryborg C et al. Treatment of acute otitis media in general practice: quality variations across countries. Family Practice. 2012 Feb;29(1):63-68. https://doi.org/10.1093/fampra/cmr042