International Journal of Pediatric Otorhinolaryngology
Adherence to treatment guidelines for acute otitis media in children. The necessity of an effective strategy of guideline implementation
Section snippets
Background
Our knowledge of how to treat diseases in the most beneficial way is always improving. Guidelines based on evidence and produced by expert panels are important means of achieving good medical quality. The difficulty in applying evidence-based conclusions to clinical practice and patient outcome is well acknowledged [1]. Acute otitis media (AOM) is the second-most common infectious diagnosis in children and the single diagnosis responsible for most prescriptions of antibiotics in children in
Methods
We first conducted a retrospective analysis of patient records from the pediatric emergency department at the Queen Silvia Children’s Hospital in Gothenburg, Sweden between January 1, 2009 and June 30, 2009. This was followed by an information campaign on the recommended principles of treatment of AOM in January and February 2010. The study was completed with a renewed retrospective analysis of patient records on visits from March 1, 2010 until June 30, 2010, and differences in management of
Results
Ninety-one patients were included in the first investigation of patient records, from a total of 1041 for the period (Fig. 1). The characteristics of the patients are given in Table 2. The adherence differed between our four endpoints, from 70% for dosage of antibiotics to 90% for duration of treatment (Table 3).
The second investigation of patient records included 80 of the 652 AOM diagnoses over the period (Table 2 and Fig. 2). No significant improvement was found in any of the four endpoints
Discussion
The objective of the study was to assess the adherence to national guidelines regarding the treatment of AOM in a hospital setting, and to determine whether a short but intense information campaign with different educational tools could modify the result. Considerable deviation from current recommendations – especially regarding the new aspects of WW – has been reported in Sweden [7]. Our hypothesis was that these deviations from recommendations were a result of lack of knowledge and that a
Conflicts of interest
The authors declare that they have no conflicts of interest.
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