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Antimicrobial prescribing for outpatient adults with acute otitis media

Abstract number: 903_r1909

Kozlov S.

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Objectives:

Acute otitis media (AOM) is a common infection requiring physician visits and prescription of systemic antimicrobials (AM) in outpatient departments all over the world. The objective of the study was to evaluate the frequency and patterns of AM prescribing for outpatient adults with AOM in European part of Russia in comparison with previously published recommendations.

Methods:

The study was carried out in randomly chosen public outpatient departments in six regions of Russia. In each department consecutive cases of AOM, registered in 2001, were selected for clinical chart evaluation. The appropriateness of AM choice was assessed in accordance with the available guidelines.

Results:

The study included 1115 patients with AOM (501 males, 614 females) aged from 17 to 83 years, average age 39.9 ± 13.8 years. AM were prescribed to 78% of patients with AOM. The recommended first-or second-line AM were used in 14.8% of cases (6.7, 7.0, 7.8, 15.5, 22.4 and 43.8% in Volgograd, Rjazan, Smolensk, Ekaterinburg, Yaroslavl and N. Novgorod, respectively). Among 33 different AM frequently prescribed as initial therapy were doxycycline, amoxicillin, ampicillin, ciprofloxacin, co-trimoxazole and lincomycin (19.5, 19.3, 16.7, 11.5, 7.2 and 6.7% of cases, respectively). Smolensk and Ekaterinburg were characterised by predominant use of ampicillin (41.7 and 30.3%, respectively), Yaroslavl–doxycycline (31.9%), Rjazan–ciprofloxacin (24.7%), Volgograd–co-trimoxazole (21.3%). The average course of AM treatment was 7.2 ± 3.4 days and varied from 5.7 ± 3.2 days in Rjazan to 9.0 ± 6.1 days in Volgograd.

Conclusions:

AM therapy is still the mainstay of AOM management in outpatient adults despite the lack of substantial evidence of their benefits. The AM choice differs significantly from current recommendations. The appropriate educational efforts should be undertaken to improve AM treatment of AOM in outpatient adults.

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Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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