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Pattern of antimicrobial drug prescribing and prescriptive behaviour for acute otitis media among physicians in
G Mazzaglia1, V Arcoraci, G Nicoletti
1School of Medicine, University of Messina, P.zza XX settembre 4, Messina, I-98122, Italy.
Abstract:
Acute otitis media (AOM) is one of the most common diseases of childhood, but it is less common in adults. Usually, in clinical practice therapy cannot wait until the laboratory report and the choice of an antibiotic prescription is initiated on an empirical basis. Moreover, several studies have shown great variability in antibiotic prescription for AOM. The study was carried out in order to describe the antibiotic prescribing pattern and the prescriptive behaviour among Sicilian general practitioners (GPs) in choosing an empirical antibiotic regimen for treatment of AOM. Each GP completed a questionnaire for each therapeutic intervention which ended with an antibiotic prescription. Diagnoses and drugs were classified according to the International Classification of Diseases (ICD-10) and to the Anatomical Therapeutic Chemical (ATC) classification system, respectively. Antibiotics, issued for AOM, accounted for 11.1% of total antimicrobial therapy in paediatrics and 3.4% in adults. The commonest therapeutic groups were: cephalosporins (44.1%), macrolides (26.1%), extended spectrum penicillins (16.1%), combination of penicillins and beta-lactamase inhibitors (11.4%). The route of administration appeared to be influenced by age of the patients, by a subjective clinical assessment of disease severity and by the presence of concurrent diseases. The diagnostic criteria and the marked variation in antibiotic prescribing pattern for AOM among Sicilian GPs reflects a lack of knowledge of any local or national guidelines.
Insights
Sicilian general practitioners show significant variability in prescribing antibiotics for acute otitis media (AOM). This pattern suggests a need for clearer guidelines on empirical antibiotic therapy for AOM in the region.
Area of Science:
- Otolaryngology
- General Practice
- Pharmacology
Background:
- Acute otitis media (AOM) is a common childhood illness, less frequent in adults.
- Empirical antibiotic prescription for AOM is standard practice due to the urgency of treatment.
- Existing research indicates considerable variation in antibiotic prescribing for AOM.
Purpose of the Study:
- To analyze antibiotic prescribing patterns and behaviors of Sicilian general practitioners (GPs).
- To investigate the empirical antibiotic regimens chosen for AOM treatment by GPs.
Main Methods:
- GPs completed questionnaires for each AOM antibiotic prescription.
- Diagnoses and drugs were classified using ICD-10 and ATC systems.
- Prescribing data for AOM were analyzed in relation to patient demographics and clinical factors.
Main Results:
- AOM antibiotic prescriptions constituted 11.1% of pediatric and 3.4% of adult antimicrobial therapy.
- Cephalosporins (44.1%), macrolides (26.1%), and extended-spectrum penicillins (16.1%) were the most common antibiotic classes.
- Prescribing variations were influenced by patient age, perceived disease severity, and comorbidities.
Conclusions:
- The diagnostic criteria and varied antibiotic prescribing patterns for AOM among Sicilian GPs highlight a deficiency in adherence to or awareness of established guidelines.
- There is a need for enhanced education and implementation of national/local guidelines for empirical AOM treatment in primary care settings.