Effect of patient characteristics and disease manifestations on the outcome of acute otitis media at 2 months
| Autor: | Jack Froom, Bowers P, Lion J, Grava-Gubins I, Yodfat Y, Larry Culpepper, Rosser W, Grob P, Bridges-Webb C, Stroobant A |
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| Rok vydání: | 1993 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Adolescent Acute otitis media medicine.drug_class Antibiotics Disease Internal medicine Outcome Assessment Health Care otorhinolaryngologic diseases medicine Confidence Intervals Odds Ratio Humans Medical history Prospective Studies Child Univariate analysis business.industry Infant General Medicine Odds ratio Confidence interval Anti-Bacterial Agents Otitis Media Treatment Outcome Child Preschool Acute Disease Regression Analysis Female business |
| Zdroj: | Archives of family medicine. 2(8) |
| ISSN: | 1063-3987 |
| Popis: | BACKGROUND Optimal therapy for acute otitis media (AOM) is controversial and there is no consensus regarding which antibiotic to use, how long to administer it, or whether antibiotics are effective at all. Knowledge of the effects of patient characteristics and disease manifestations is needed to individualize treatment and to evaluate large-scale trials. METHODS Data originated from 2251 patients with AOM, aged newborn to 15 years, who participated in a prospective primary care study in eight countries. At the initial visit, medical history, symptoms, physical findings, and treatment data were recorded. Follow-up 2 months later identified changes in treatment and outcome. RESULTS Patients younger than 13 months were less likely to have recovered than those aged 13 months to 15 years (P = .05). Using univariate analysis for infants aged 12 months or younger, male sex, prior episodes of AOM, and serous otitis media were associated with poor outcome. For older patients, poor outcome was associated with initial history of ear tubes, prophylactic antibiotic use, ear discharge, decreased hearing, serous otitis media; and past episodes of AOM; the symptom of decreased hearing; and the finding of pus exuding from the tympanic membrane. Using multivariate analysis for infants aged 12 months or younger, a history of serous otitis media (odds ratio [OR], 2.3; 95% confidence interval [CI], 0.95-5.7), past episodes of AOM (OR, 1.9; 95% CI, 0.82-4.5), and male sex (OR, 1.7; 95% CI, 1.0-3.0) made independent contributions to poor outcome. For children aged 13 months to 15 years, significant variables included pus drainage (OR, 2.2; 95% CI, 1.5-3.3), a history of ear tubes (OR, 2.3; 95% CI, 1.5-3.6), past episodes of AOM (OR, 1.8; 95% CI, 1.3-2.34), and a history of serous otitis media (OR, 1.4; 95% CI, 1.0-1.9). CONCLUSIONS Patient characteristics and disease manifestations are significant determinants of AOM outcome. |
| Databáze: | OpenAIRE |
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