儿童急性中耳炎诊断治疗指南.pdf

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1、AMERICANACADEMYOFPEDIATRICSANDAMERICANACADEMYOFFAMILYPHYSICIANSCLINICALPRACTICEGUIDELINESubcommitteeonManagementofAcuteOtitisMediaDiagnosisandManagementofAcuteOtitisMediaABSTRACT.Thisevidence-basedclinicalpracticeasignificantimpactonthehealthofchildren,costofguidelineprovidesrecommendation

2、stoprimarycarecli-providingcare,andoveralluseofantibacterialniciansforthemanagementofchildrenfrom2monthsagents.Theillnessalsogeneratesasignificantsocialthrough12yearsofagewithuncomplicatedacuteotitisburdenandindirectcostduetotimelostfromschoolmedia(AOM).andwork.TheestimateddirectcostofAOMw

3、asTheAmericanAcademyofPediatricsandAmerican$1.96billionin1995.Inaddition,theindirectcostAcademyofFamilyPhysiciansconvenedacommitteewasestimatedtobe$1.02billion.1During1990therecomposedofprimarycarephysiciansandexpertsinthefieldsofotolaryngology,epidemiology,andinfectiouswerealmost25million

4、visitsmadetooffice-baseddisease.ThesubcommitteepartneredwiththeAgencyphysiciansintheUnitedStatesforotitismedia,withforHealthcareResearchandQualityandtheSouthern809antibacterialprescriptionsper1000visits,foraCaliforniaEvidence-BasedPracticeCentertodevelopatotalofmorethan20millionprescriptio

5、nsforotitiscomprehensivereviewoftheevidence-basedliteraturemedia–relatedantibacterials.AlthoughthetotalrelatedtoAOM.Theresultingevidencereportandothernumberofofficevisitsforotitismediadecreasedtosourcesofdatawereusedtoformulatethepracticeguide-16millionin2000,therateofantibacterialprescrib

6、-linerecommendations.Thefocusofthispracticeguide-ingwasapproximatelythesame(802antibacteriallineistheappropriatediagnosisandinitialtreatmentofprescriptionsper1000visitsforatotalofmorethanachildpresentingwithAOM.TheguidelineprovidesaspecificdefinitionofAOM.13millionprescriptions).2–4Anindiv

7、idualcourseofItaddressespainmanagement,initialobservationversusantibacterialtherapycanrangeincostfrom$10toantibacterialtreatment,appropriatechoicesofantibacte-morethan$100.rials,andpreventivemeasures.DecisionsweremadeTherehasbeenmuchdiscussionrecentlyastotheba