The Clinical Practice Guidelines for Acute Otitis Media in Children was published by the Japan Otological Society, Japan Society for Pediatric Otorhinolaryngology, and Japan Society for Infectious Diseases in Otolaryngology in 2006 indicate the basic position of these societies on the treatment of otitis media.
The Clinical Practice Guidelines was used to classify the severity of acute otitis media (AOM) in 217 pediatric outpatients under 4 years old who were diagnosed with simple AOM at this hospital and then used to treat those patients.
The Clinical Practice Guidelines was used to coordinate treatment with two otorhinolaryngology clinics in this city. Criteria for referral to Otorhinolaryngology were tympanic membrane findings indicative of moderate to severe AOM; being under 1 year of age (not all patients); a markedly lower tympanic membrane score following primary, secondary, and tertiary treatment; relapsing AOM during treatment; and protracted AOM lasting 3 weeks or longer. During referral, the patient's severity score, AOM severity, treatment, course of illness, and results of a nasopharyngeal culture were noted on the patient's chart. As a result of using
The Clinical Practice Guidelines, the referral rate was 36.8% and the myringotomy rate was 22.1%. Use of
The Clinical Practice Guidelines allowed pediatricians in this Department to adopt the same basic policy on treatment as otolaryngologists and facilitated coordination between these specialists. In the future, pediatricians also should increase their use of
The Clinical Practice Guidelines and coordinate closely with otolaryngologists.
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