Zusammenfassung
Hintergrund: Postuliert wird ein Versorgungsproblem in Diagnostik und Therapie der akuten Otitis
media im Kindesalter. Die diagnostischen Kriterien entsprechen häufig nicht dem Stand
der Wissenschaft und unterscheiden sich je nach persönlichen Präferenzen. Antibiotika
werden häufiger verordnet als erforderlich. Methode: Publikationen und Leitlinien zum Thema wurden nach den Kriterien der evidenzbasierten
Medizin bewertet, die Ergebnisse zu einer klinisch-praktischen Leitlinie zusammengefasst.
Ergebnis: Die Leitlinie beschreibt das diagnostische Prozedere und den Weg der Entscheidungsfindung
zu einer rationalen Pharmakotherapie.
Abstract
Acute Otitis media is one of the most common acute respiratory infections managed
in primary care and the most common infection among in children. Diagnostic criteria,
however, do not always correspond to scientific evidence. They often differ depending
on individual preferences and competences. Treatment, also, is controversial. In Germany,
most children attending their pediatrician or primary care physiscian will be prescribed
antibiotics. Evidence from several randomized studies and systematic reviews suggests
that routine usage of antibiotics provides only modest benefit. The benefit of prescribing
antibiotics should not only be balanced against the increased likelihood of side effects
such as diarrhoea but also against the potential to contribute to longterm antibiotic
resistance.
Schlüsselwörter
Otitis media - Mittelohrentzündung - Diagnose/Therapie - Antibiotikatherapie - evidenzbasierte
Leitlinie - Pädiatrie
Key words
Otitis media - diagnosis/therapy - antibiotic treatment - evidencebased practice-guideline
- pediatrics
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