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A Questionnaire-Based Survey of Indian ENT Surgeons to Estimate Clinic Prevalence of Acute Otitis Media, Diagnostic Practices, and Management Strategies

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Abstract

Acute otitis media (AOM) is common in Indian children, but there is limited published information on its clinic prevalence, clinicians’ diagnostic practices, and their management strategies. We approached 649 ear-nose-throat (ENT) surgeons to assess these aspects of AOM. We conducted the survey between May 2010 and February 2011 with the same set of ENT surgeons practising across India, once each during summer, monsoon and winter, using a validated 36-item questionnaire to record their reflective recall. 78 % (506/649) of approached ENT surgeons responded. The clinic prevalence of AOM was 43 % with peaks reported in July and December. 96 % (486/506) of the surgeons used otoscopy to diagnose AOM. 86 % (435/506) prescribed analgesics, and 89 % (449/506) prescribed decongestants. 98 % (495/506) treated AOM with an antibiotic at initial consultation: amoxicillin/clavulanic acid 78 % (395/506), amoxicillin 29 % (144/506), cefpodoxime 29 % (149/506), cefixime 28 % (141/506) and azithromycin 27 % (134/506). Amoxicillin/clavulanic acid 32 % (162/506) and cefpodoxime 27% (137/506) were mostly prescribed for relapse. The average reported duration of initial antibiotic therapy was 7 days and for relapse was 9 days. The reported clinic prevalence of AOM was higher (43 %) than anticipated (about 10 %) in ENT practice. Almost all the ENT surgeons used an otoscope to diagnose AOM. Amoxicillin/clavulanic acid was the preferred antibiotic for treating AOM either initially or for relapse. Most surgeons also used analgesics and decongestants for symptomatic relief.

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References

  1. Rupa V, Jacob A, Joseph A (1999) Chronic suppurative otitis media: prevalence and practices among rural south Indian children. Int J Pediatr Otorhinolaryngol 48:217–221

    Article  CAS  PubMed  Google Scholar 

  2. Jacob A, Rupa V, Job A, Joseph A (1997) Hearing impairment and otitis media in a rural primary school in south India. Int J Pediatr Otorhinolaryngol 39:133–138

    Article  CAS  PubMed  Google Scholar 

  3. Sophia A, Isaac R, Rebekah G, Brahmadathan K, Rupa V (2010) Risk factors for otitis media among preschool, rural Indian children. Int J Pediatr Otorhinolaryngol 74:677–683

    Article  CAS  PubMed  Google Scholar 

  4. Williams G, Ramachandran K, Nall L, Fong J, Mathews J (2009) Management of post-infectious olfactory dysfunction: a nationwide survey of UK ENT consultants. B-ENT 5:163–167

    Google Scholar 

  5. Gaur K, Kasliwal N, Bhandari A, Amisha B, Gupta V, Gupta R (2009) Changing trends in otorhinolaryngological diseases at a non government clinic in Jaipur. Indian J Otolaryngol Head Neck Surg 61:173–178

    Article  PubMed Central  PubMed  Google Scholar 

  6. Auinger P, Lanphear B, Kalkwarf H, Mansour M (2003) Trends in otitis media among children in the United States. Pediatrics 112:514–520

    Article  PubMed  Google Scholar 

  7. Kerschner JE (2007) Otitis media. In: Kliegman R, Marcdante K, Jenson H, Behrman R (eds) Nelsons text book of pediatrics, 18th edn. Saunders, Philadelphia, pp 2632–2646

    Google Scholar 

  8. Teele D, Klein J, Rosner B (1989) Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 160:83–94

    Article  CAS  PubMed  Google Scholar 

  9. Zaman K, Baqui AH, Yunus M, Sack RB, Bateman OM, Chowdhury HR, Black RE (1997) Acute respiratory infections in children: a community-based longitudinal study in rural Bangladesh. J Trop Pediatr 43:133–137

    Article  CAS  PubMed  Google Scholar 

  10. Rao BL, Banerjee K (1993) Influenza surveillance in Pune, India, 1978–90. Bull World Health Organ 71:177–181

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Laine MK, Tähtinen PA, Ruuskanen O, Huovinen P, Ruohola A (2010) Symptoms or symptom-based scores cannot predict acute otitis media at otitis-prone age. Pediatrics 125:e1154–e1161

    Article  PubMed  Google Scholar 

  12. Ruuskanen O, Heikkinen T (1994) Otitis media: etiology and diagnosis. Pediatr Infect Dis J 13:S23–S26

    Article  CAS  PubMed  Google Scholar 

  13. de Melker RA (1993) Evaluation of the diagnostic value of pneumatic otoscopy in primary care using the results of tympanometry as a reference standard. Br J Gen Pract 43:22–24

    PubMed Central  PubMed  Google Scholar 

  14. Pichichero ME (2000) Acute otitis media: part I. Improving diagnostic accuracy. Am Fam Physician 61:2051–2056

    CAS  PubMed  Google Scholar 

  15. American Academy of Pediatrics and American Academy of Family Physicians (2004) Clinical practice guideline, subcommittee on management of acute otitis media. Diagnosis and management of acute otitis media. Pediatrics 113:1451–1465

    Article  Google Scholar 

  16. Klein JO (2011) Is acute otitis media a treatable disease? N Engl J Med 364:168–169

    Article  CAS  PubMed  Google Scholar 

  17. IAP Respiratory Chapter (2012) Protocols in pulmonology. http://www.iaprespiratory.org/index.html. Accessed 15 March 2012

  18. Courter JD, Baker WL, Nowak KS, Smogowicz LA, Desjardins LL, Coleman CI et al (2010) Increased clinical failures when treating acute otitis media with macrolides: a meta-analysis. Ann Pharmacother 44:471–478

    Article  CAS  PubMed  Google Scholar 

  19. Coleman C, Moore M (2008) Decongestants and antihistamines for acute otitis media in children. Cochrane Database Syst Rev 16(3):CD001727

    Google Scholar 

  20. MacArthur CJ, DeGagne JM, Kempton JB, Trune DR (2009) Steroid control of acute middle ear inflammation in a mouse model. Arch Otolaryngol Head Neck Surg 135:453–457

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

“We thank Dr. E. V. Raman and his team at Center for Otitis Media Research and Education (CORE) for ratifying the questionnaire for content validity. We thank Drs. Chinnappa J, Kukreja S, Mankekar G, Prabhat D, Rai D, Raman E V and Ugra D, for their contribution towards interpretation of findings from this survey and for review of the manuscript.” This questionnaire survey was funded by GlaxoSmithKline Pharmaceuticals Ltd. (GSK), Mumbai. This work is attributed to GlaxoSmithKline Pharmaceuticals Ltd. Mumbai.

Conflict of interest

Dr. Arun Nanivadekar is an independent medical research consultant who received a fee from GSK for advice on this project.

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Correspondence to Liesel D’silva.

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D’silva, L., Parikh, R., Nanivadekar, A. et al. A Questionnaire-Based Survey of Indian ENT Surgeons to Estimate Clinic Prevalence of Acute Otitis Media, Diagnostic Practices, and Management Strategies. Indian J Otolaryngol Head Neck Surg 65 (Suppl 3), 575–581 (2013). https://doi.org/10.1007/s12070-012-0545-2

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