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Pharmacological treatment of acute otitis media in children. A comparison among seven locations: Tenerife, Barcelona and Valencia (Spain), Toulouse (France), Smolensk (Russia), Bratislava (Slovakia) and Sofia (Bulgaria)

  • Pharmacoepidemiology and Prescription
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Abstract

Objective

To describe patterns observed in the treatment of acute otitis media (AOM) in several locations of five countries.

Patients and methods

Cross-sectional, descriptive study. Random sample of 12,264 paediatric outpatients seen by paediatricians or general practitioners (GPs). Data on patient demographics, diagnoses and treatment were collected. Diagnoses were coded by ICD-9 and drugs by ATC classification. Patients diagnosed with AOM (ICD-9 codes: 381 and 382) were selected for analysis.

Results

Cases of AOM (873) accounted for 7.1% of the sample. There is a clear variation in the percentage of children diagnosed with AOM and treated with antibiotics in the different locations, antibiotic prescriptions being higher in Barcelona (93% of children), and lowest in Smolensk (56.4 % of children were treated without antibiotics). The antibiotics used varied widely: ampicillin use is almost limited to Smolensk (26.7%) and Bratislava (13.8%), whereas amoxicillin plus clavulanic acid is the choice in Toulouse (33.8%), Valencia (30.2%) and Barcelona (28.9%), and cephalosporins are more frequently prescribed in Tenerife (51.7%). Finally, macrolides are used in Barcelona (18.3%), Valencia (17.5%) and Tenerife (13.6%), but not prescribed in Toulouse or Sofia. Prescriptions of anti-inflammatory drugs were only relevant in Valencia (31.7%), Tenerife (27.2%) and Toulouse (17.4%) and of otological preparations in Sofia, where almost each child received ear drops (91.9%). Nasal preparations are commonly used only in Sofia (41.9%), Bratislava (65.5%) and Smolensk (68.6%).

Conclusion

Despite the general agreement of most guidelines, wide differences in the treatment of uncomplicated AOM in children are observed. Non-antibiotic therapy for AOM and the use of first-choice antibiotics should be more actively encouraged in the primary care centres. Studies to measure prevailing rates of antibiotic resistance in these populations are needed.

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Authors and Affiliations

  1. Department of Clinical Pharmacology, School of Medicine, University of La Laguna, 38071 La Laguna, Tenerife, Spain

    E. Sanz, M. A. Hernández & M. Kumari

  2. State Medical Academy, Department of Clinical Pharmacology, Smolensk, Russia

    S. Ratchina & L. Stratchounsky

  3. CAP San Gervasio, Instituto Catalán de la Salud (ICS), Barcelona, Spain

    M. A. Peiré

  4. Department of Clinical Pharmacology, School of Medicine, Toulouse University, France

    M. Lapeyre-Mestre & B. Horen

  5. Department of Clinical Pharmacology, Comenius University, Bratislava, Slovakia

    M. Kriska & H. Krajnakova

  6. National Drug Agency, Ministry of Health, Sofia, Bulgaria

    H. Momcheva & D. Encheva

  7. Hospital Management, Valencia University General Hospital Consortium and HGU Foundation, Spain

    I. Martínez-Mir

  8. Service of Internal Medicine, Hospital de la Ribera, Alzira, Valencia, Spain

    V. Palop

Authors
  1. E. Sanz
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  2. M. A. Hernández
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  3. M. Kumari
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  8. B. Horen
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  9. M. Kriska
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  11. H. Momcheva
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  13. I. Martínez-Mir
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  14. V. Palop
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Corresponding author

Correspondence to E. Sanz.

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Sanz, E., Hernández, M.A., Kumari, M. et al. Pharmacological treatment of acute otitis media in children. A comparison among seven locations: Tenerife, Barcelona and Valencia (Spain), Toulouse (France), Smolensk (Russia), Bratislava (Slovakia) and Sofia (Bulgaria). Eur J Clin Pharmacol 60, 37–43 (2004). https://doi.org/10.1007/s00228-003-0720-1

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  • DOI: https://doi.org/10.1007/s00228-003-0720-1

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