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Effect of Antibiotics for Otitis Media on Mastoiditis in Children_ A ...课件
Effect of Antibiotics for Otitis Media on Mastoiditis in Children: A Retrospective Cohort Study Using the United Kingdom General Practice Research Database Pediatric Residents’ Journal Club February 5, 2009 Sara Szkola Paula Louise Thompson, Ruth E. Gilbert, Paul F. Long, Sonia Saxena, Mike Sharland, and Ian Chi Kei Wong Pediatrics 2009; 123: 424-430 Background Otitis media is the main reason children visit their doctor in the UK Though most cases of otitis media are self-limiting, rarely children can go on to develop complications such as mastoiditis Antibiotic prescriptions for otitis media have decreased in recent years, and other studies have documented a concurrent increase in hospital admissions (1, 2, 3) This study aimed to determine if this is a causal relationship between decreased antibiotic use and increased complications (ie, mastoiditis), or if it is due to changes in “access to services, referral patterns and coding of routine data” That is, does it make sense to give antibiotics for otitis media for the purpose of preventing mastoiditis? Study Design Data were drawn from the General Practice Research Database, a database that draws from practices all over the UK and includes information on all active patients Children aged 3 months to 15 years who were in this database from 1990-2006 were included 2 exclusions: children who weren’t with “up to standard” practice (MD not recording all data), and “temporarily registered” children (ie, 1 visit to different MD than their own) Study Design Continued Data Analysis Age specific incidence rates (along with calendar-year specific incidence rates) for mastoiditis with and without otitis media were calculated per 1000 child years at risk Incidence rates were also calculated for otitis media and for antibiotic-prescribing for otitis media Then they calculated the relative risk of children with otitis media developing mastoiditis with and without antibiotc treatment What are all these statistics? Incidence rat
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