domenica 5 agosto 2007

Otite media acuta nei bambini: scarsa aderenza da parte dei medici alle indicazioni della letteratura

Numerosi studi e soprattutto le Linee Guida dell'American College of Pediatrics suggeriscono nelle infezioni dell'orecchio nei bambini di 2 anni o più grandi un atteggiamento "wait and see" volto a contenere l'uso eccessivo e inutile di antibiotici.
Un recente studio pubblicato su Pediatrics evidenzia come questo approccio sia disatteso da gran parte dei Pediatri Americani (e credo anche Italiani) che lo utilizzano in meno del 20% dei casi.
Le cause addotte sono le difficoltà nel rapporto con i genitori e nel poter controllare giornalmente i bambini.


Physicians Not Following Guidelines for Treating Ear Infections

Physicians are not adhering to the guidelines for treating acute otitis media outlined by the American Academy of Pediatrics and American Academy of Family Physicians in 2004, according to a study in Pediatrics.

The guidelines endorse an observation option, rather than antibiotics, for some children with ear infections, particularly those who are aged 2 or older who do not have severe symptoms.

Over 200 physicians responded to surveys in 2004 and again in 2006. In both years, about 80% of the physicians considered the observation option reasonable for some children. However, they reported using the observation option in a median of 15% of the cases they had diagnosed in the past 3 months.

Nearly two-thirds of the physicians said parental reluctance was the top barrier to using the observation option. One-third of the physicians said the cost and difficulty in following-up with children were important barriers. (New York State's Department of Health offers a "viral prescription" to make it easier to explain to parents that viral infections don't respond to antibiotics.)

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