儿童急性耳炎:对诊断和抗生素治疗方案的范围审查
Niccolò Parri1, Silvia Bettelli2, Flavio Storelli1
1Meyer Children's Hospital IRCCS, Florence, Italy.
European journal of pediatrics
|August 12, 2025
概括
目前的急性耳炎 (AM) 管理涉及长时间的静脉注射抗生素,没有强有力的证据. 这次审查强调了对儿童无并发性AM的较短,口服抗生素疗程的研究的需要.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 传染性疾病 传染性疾病
- 基于证据的医学基于证据的医学.
背景情况:
- 急性耳炎 (AM) 是一个常见的儿科耳部感染.
- 目前的管理通常涉及长时间的静脉注射 (IV) 抗生素治疗.
- 缺乏高质量的证据指导最佳治疗持续时间和途径.
研究的目的:
- 系统地审查当前关于儿科患者无并发性急性耳炎 (AM) 管理的文献.
- 分析抗生素治疗方案和成像在诊断和并发症检测中的作用.
- 识别证据上的差距,以建立最佳实践.
主要方法:
- 对2000年至2025年间发表的研究进行了系统的文献搜索.
- 资格标准包括儿科患者 (<18岁) 和英语出版物.
- 该审查遵循PRISMA ScR指南,分析了81项涉及11,919名患者的研究.
主要成果:
- 大多数研究是观察性/回顾性;经常使用CT成像 (36.8%的患者).
- 所有住院的患者都接受了经验性亲肠道抗生素,通常是第三代头素.
- 转向口服抗生素发生在30.9%的研究中,总治疗持续时间从4天到30天.
结论:
- 目前的AM治疗严重依赖于长时间的静脉注射抗生素,有限的证据支持早期口服抗生素过渡.
- 由于缺乏高质量的试验,临床实践存在显著的变化.
- 展望性研究对于开发潜在更保守的治疗方法的基于证据的指导方针至关重要.
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