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Factors affecting the antimicrobial changes during treatment for acute otitis media in Japan: A retrospective cohort
Masamitsu Kono1, Daichi Murakami1, Hideki Sakatani1
1Department of Otorhinolaryngology Head and Neck Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, Wakayama, 641-8510, Japan.
Insights
Hospital size and patient registration history influence antimicrobial changes in pediatric acute otitis media (AOM). Antimicrobial stewardship programs are key to promoting appropriate AOM treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Appropriate antimicrobial use is crucial for managing pediatric acute otitis media (AOM).
- Understanding factors influencing antimicrobial treatment changes is essential for optimizing AOM care.
Purpose of the Study:
- To investigate factors affecting changes in first-line antimicrobial agents for pediatric AOM.
- To promote the appropriate use of antimicrobials in AOM treatment.
Main Methods:
- Descriptive study utilizing an electronic medical records database.
- Analysis of 16,353 pediatric AOM patients (1996-2019) using classification and regression trees (CART).
- Factors influencing antimicrobial agent changes within 14 days were analyzed.
Main Results:
- Facility size (number of beds) and historical patient registration duration impacted antimicrobial changes.
- 4,860 cases of AOM alone and 9,567 cases of AOM with comorbidities were analyzed.
Conclusions:
- Hospital-wide or nation-wide antimicrobial stewardship promotion significantly influences antimicrobial changes.
- Accurate diagnosis and clear definitions of treatment failure are vital for AOM cases with comorbidities.
- This study provides insights to enhance appropriate antimicrobial utilization in AOM management.
Objectives:
Factors that affect the change of first-line antimicrobial agents were investigated to further promote their appropriate use.
Methods:
This descriptive study used an electronic medical records database. Total 16,353 of the 199,896 patients enrolled between 1996 and 2019 met the inclusion criteria and formed the overall pediatric acute otitis media (AOM) cohort. The factors leading to the change in first-line antimicrobial agents within 14 days were analyzed using classification and regression trees (CART) analysis.
Results:
This antimicrobial treatment cohort, involved 4860 cases of AOM alone and 9567 cases of AOM with other diseases. The size of the medical facility based on number of beds and historical duration of patient registration impacted on antimicrobial changes.
Conclusions:
The current results show that hospital-wide or nation-wide antimicrobial stewardship promotion could be the most influencing factor for antimicrobial changes. Particularly in cases of AOM where other diseases coexist, a more accurate diagnosis and definition of treatment failure of first-line drug are suggested to be important while establishing future treatment strategies. The current study is important to promote appropriate antimicrobial use for AOM treatment.
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