The Diagnosis and Management of Acute Otitis Media
The Diagnosis and Management of Acute Otitis Media
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DOI：
10.1542/peds.2012-3488
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发表时间：
2013-03-01
期刊：
影响因子：
8
通讯作者：
Tunkel, David E.
中科院分区：
文献类型：
--
作者：
Lieberthal, Allan S.;Carroll, Aaron E.;Tunkel, David E.
本循证临床实践指南是美国儿科学会（AAP）和美国家庭医生学会2004年急性中耳炎（AOM）指南的修订版。2009年，AAP召集了一个由初级保健医生和儿科、家庭医学、耳鼻喉科、流行病学、传染病、急诊医学和指南方法学领域的专家组成的委员会。该小组委员会与医疗保健研究和质量局和南加州循证实践中心合作，对自2000年首次证据报告以来与AOM相关的新文献进行了全面综述。由此产生的证据报告和其他来源的数据被用来制定实践指南recommendations. This实践指南的重点是适当的诊断和初步治疗的儿童呈现AOM。该指南提供了AOM的具体、严格定义。它涉及疼痛管理，初始观察与抗生素治疗，抗生素药物的适当选择和预防措施。它还涉及经常性的AOM，这是2004年指南中没有包括的。根据证据质量和获益-损害关系的系统分级做出决定。在AAP正式批准之前，该临床实践指南进行了全面的同行评审。该临床实践指南并非旨在作为AOM儿童管理的唯一指导来源。相反，它旨在通过提供临床决策框架来帮助初级保健临床医生。它并不打算取代临床判断或建立一个协议，为所有儿童与这种情况。这些建议可能不是处理这一问题的唯一适当办法。儿科2013;131：e964-e999
This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships. The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Pediatrics 2013;131:e964-e999