Akute Otitis media (AOM) bei Kindern (ICD: H66.0): eine evidenzbasierte Leitlinie

 

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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.

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