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Acute mastoiditis in children in Sweden 1993-2007-No increase after new guidelines.

Groth, Anita; Enoksson, Frida LU ; Hermansson, Ann LU ; Hultcrantz, Malou; Stalfors, Joacim and Stenfeldt, Karin LU (2011) In International Journal of Pediatric Otorhinolaryngology 75(12). p.1496-1501
Abstract
OBJECTIVE: To study whether the incidence and characteristics of acute mastoiditis in children changed in Sweden following the introduction of new guidelines for diagnosis and treatment of acute otitis media advocating "watchful waiting" as an option in children 2-16 years of age with uncomplicated acute otitis media. METHODS: The records for all patients treated for mastoiditis during 1993-2007 at all Ear, Nose and Throat departments in Sweden were reviewed retrospectively according to defined criteria for acute mastoiditis. In this study the data from children aged 0-16 years were analyzed and compared 71/2 years before and 71/2 years after the introduction of the new guidelines in 2000. RESULTS: A total of 577 cases aged 0-16 years... (More)
OBJECTIVE: To study whether the incidence and characteristics of acute mastoiditis in children changed in Sweden following the introduction of new guidelines for diagnosis and treatment of acute otitis media advocating "watchful waiting" as an option in children 2-16 years of age with uncomplicated acute otitis media. METHODS: The records for all patients treated for mastoiditis during 1993-2007 at all Ear, Nose and Throat departments in Sweden were reviewed retrospectively according to defined criteria for acute mastoiditis. In this study the data from children aged 0-16 years were analyzed and compared 71/2 years before and 71/2 years after the introduction of the new guidelines in 2000. RESULTS: A total of 577 cases aged 0-16 years fulfilled the inclusion criteria during the whole study period. Cases involving cholesteatoma were excluded. The number of children affected by acute mastoiditis did not increase after the introduction of new guidelines. Acute mastoiditis was most common in children younger than two years of age. The proportion of acute mastoiditis increased after 2000 in the group aged 2-23 months although they were not affected concerning treatment by the new guidelines. No decrease was found in the frequency of prehospital antibiotic treatment among the children admitted with acute mastoiditis, and no increase was seen in the duration of ear symptoms before hospital admission, duration of hospital stay, or in the frequency of complications or mastoidectomies, after the introduction of the new guidelines in either group of children. CONCLUSIONS: The incidence of acute mastoiditis in children in Sweden did not increase following the introduction of new guidelines in 2000 for the diagnosis and treatment of acute otitis media. This is despite the fact that a significant decrease in antibiotic prescriptions for otitis media has been reported during the same time period. The characteristics of acute mastoiditis reflecting severity of illness did not change over time. Acute mastoiditis was most common and increased after 2000 only in children younger than two years of age in which antibiotics were still recommended in all cases of acute otitis media. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute mastoiditis, Acute otitis media, Children, Complications, Guidelines, Incidence
in
International Journal of Pediatric Otorhinolaryngology
volume
75
issue
12
pages
1496 - 1501
publisher
Elsevier
external identifiers
  • wos:000297491200004
  • pmid:21945244
  • scopus:80055041207
ISSN
1872-8464
DOI
10.1016/j.ijporl.2011.08.015
language
English
LU publication?
yes
id
3fb4abfa-bcec-4053-b31f-4b12d5a692f6 (old id 2168414)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21945244?dopt=Abstract
date added to LUP
2011-10-03 14:22:03
date last changed
2017-11-05 03:06:47
@article{3fb4abfa-bcec-4053-b31f-4b12d5a692f6,
  abstract     = {OBJECTIVE: To study whether the incidence and characteristics of acute mastoiditis in children changed in Sweden following the introduction of new guidelines for diagnosis and treatment of acute otitis media advocating "watchful waiting" as an option in children 2-16 years of age with uncomplicated acute otitis media. METHODS: The records for all patients treated for mastoiditis during 1993-2007 at all Ear, Nose and Throat departments in Sweden were reviewed retrospectively according to defined criteria for acute mastoiditis. In this study the data from children aged 0-16 years were analyzed and compared 71/2 years before and 71/2 years after the introduction of the new guidelines in 2000. RESULTS: A total of 577 cases aged 0-16 years fulfilled the inclusion criteria during the whole study period. Cases involving cholesteatoma were excluded. The number of children affected by acute mastoiditis did not increase after the introduction of new guidelines. Acute mastoiditis was most common in children younger than two years of age. The proportion of acute mastoiditis increased after 2000 in the group aged 2-23 months although they were not affected concerning treatment by the new guidelines. No decrease was found in the frequency of prehospital antibiotic treatment among the children admitted with acute mastoiditis, and no increase was seen in the duration of ear symptoms before hospital admission, duration of hospital stay, or in the frequency of complications or mastoidectomies, after the introduction of the new guidelines in either group of children. CONCLUSIONS: The incidence of acute mastoiditis in children in Sweden did not increase following the introduction of new guidelines in 2000 for the diagnosis and treatment of acute otitis media. This is despite the fact that a significant decrease in antibiotic prescriptions for otitis media has been reported during the same time period. The characteristics of acute mastoiditis reflecting severity of illness did not change over time. Acute mastoiditis was most common and increased after 2000 only in children younger than two years of age in which antibiotics were still recommended in all cases of acute otitis media.},
  author       = {Groth, Anita and Enoksson, Frida and Hermansson, Ann and Hultcrantz, Malou and Stalfors, Joacim and Stenfeldt, Karin},
  issn         = {1872-8464},
  keyword      = {Acute mastoiditis,Acute otitis media,Children,Complications,Guidelines,Incidence},
  language     = {eng},
  number       = {12},
  pages        = {1496--1501},
  publisher    = {Elsevier},
  series       = {International Journal of Pediatric Otorhinolaryngology},
  title        = {Acute mastoiditis in children in Sweden 1993-2007-No increase after new guidelines.},
  url          = {http://dx.doi.org/10.1016/j.ijporl.2011.08.015},
  volume       = {75},
  year         = {2011},
}