{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:14:51Z","timestamp":1789132491175,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T00:00:00Z","timestamp":1550620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective descriptive cohort study of patients \u226415\u2009years of age who presented to two EDs in Southeast Queensland between January 2016 and June 2017 with an ED diagnosis of AOM. Likelihood of diagnosis was based on medical records and classified as likely, possible or unlikely using paediatric practice guidelines. Appropriateness of antibiotics prescription was classified using the National Antibiotic Prescribing Survey, which takes into account adherence to the Australian Therapeutic Guidelines. Each medical record was extracted by two blinded reviewers, and discrepancies were resolved by consensus or arbitration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 305 patients included for analysis, 87% had a likely or possible diagnosis of AOM. Otalgia was the presenting complaint in 75%. Standard otoscopy was the routine method for tympanic membrane visualisation, and 70% had abnormal tympanic membrane findings. Almost two\u2010thirds (62%) of all children were prescribed antibiotics. Antibiotic appropriateness could be ascertained for 286 patients (94%). A total of 39% received inappropriate antibiotic management for AOM. The majority of patients received analgesia in the form of paracetamol and\/or ibuprofen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ED clinicians make the diagnosis of AOM fairly accurately, although better assessment of the tympanic membrane by tympanometry and\/or pneumatic otoscopy may improve accuracy. More than one\u2010third of patients are prescribed antibiotics inappropriately. Our data can inform knowledge translation and education strategies to ensure the correct evidence\u2010based management of this condition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14414","type":"journal-article","created":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T01:16:09Z","timestamp":1550711769000},"page":"1335-1343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?"],"prefix":"10.1111","volume":"55","author":[{"given":"Niroshan","family":"Balasundaram","sequence":"first","affiliation":[{"name":"The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dung","family":"Phan","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"School of Medicine, Bond University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mazzoni","sequence":"additional","affiliation":[{"name":"School of Medicine, Bond University  Brisbane Queensland Australia"},{"name":"Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Gold Coast University Hospital  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Sweeny","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Gold Coast University Hospital  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Del Mar","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine Bond University  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-4552","authenticated-orcid":false,"given":"Gerben","family":"Keijzers","sequence":"additional","affiliation":[{"name":"School of Medicine, Bond University  Brisbane Queensland Australia"},{"name":"Department of Emergency Medicine Gold Coast University Hospital  Gold Coast Queensland Australia"},{"name":"School of Medicine, Griffith University  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s13063-016-1247-y","article-title":"A multi\u2010centre open\u2010label randomised noninferiority trial comparing watchful waiting to antibiotic treatment for acute otitis media without perforation in low\u2010risk urban Aboriginal and Torres Strait Islander children (the WATCH trial): Study protocol for a randomised controlled trial","volume":"17","author":"Abbott P","year":"2016","journal-title":"Trials"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2009.tb02931.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY16096"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-014-0181-x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1651"},{"key":"e_1_2_7_7_1","unstructured":"Royal Children's Hospital Melbourne.Acute Otitis Media. Melbourne: The Hospital; 2018. Available from:https:\/\/www.rch.org.au\/clinicalguide\/guideline_index\/Acute_otitis_media\/[accessed 25 November 2017]."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.5.1451"},{"key":"e_1_2_7_9_1","volume-title":"NHG Guidelines for General Practitioners","author":"Damoiseaux RAMJ","year":"2014"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000184"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/jpc.13549","article-title":"Duration of antibiotics for acute otitis media in under 2 year olds","volume":"53","author":"Isaacs D","year":"2017","journal-title":"J. Paediatr. Child Health"},{"key":"e_1_2_7_12_1","unstructured":"University of Bern Switzerland Group.STROBE Statement Checklist for Cohort Studies.Bern: University of Bern Switzerland Group; 2009. Available from:https:\/\/www.strobe-statement.org\/index.php?id=available-checklists[accessed 4 January 2018]."},{"key":"e_1_2_7_13_1","unstructured":"Acute Otitis Media.National Antimicrobial Prescribing Survey.Melbourne: Melbourne Health; 2018. Available from:https:\/\/www.naps.org.au[accessed 9 January 2018]."},{"key":"e_1_2_7_14_1","unstructured":"Therapeutic Guidelines.Melbourne: Therapeutic Guidelines Ltd; 2019. 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