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Vol. 60. Núm. 2.
Páginas 125-132 (Febrero 2004)
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Vol. 60. Núm. 2.
Páginas 125-132 (Febrero 2004)
DOI: 10.1016/S1695-4033(04)78232-6
Acceso a texto completo
Epidemiología e impacto de la otitis media aguda en la Comunidad Valenciana
Epidemiology and burden of acute otitis media in valencia (spain)
Visitas
...
M. Garcés-Sánchez
Autor para correspondencia
maria_garces@terra.es

Correspondencia: Ambulatorio Francisco Cortina. Santos Patronos, 35. 46900 Valencia. España
, J. Díez-Domingo, T. Álvarez de Labiada, V. Planelles, M. Graullera, J.M.a Baldo, L.A. García Llop, M. García López, A. Peris Vidal, M.aD. Gallego García, A. Ballester Sanz, C. Peidro, J. Villarroya, A. Jubert, J. Colomer Revuelta, C. Casani
Pediatras de Atención Primaria. Instituto de Vacunas de Valencia (VIVA). España
Información del artículo
Objetivo

Estimar el impacto (incidencia, tratamiento y complicaciones) de la otitis media aguda (OMA) y la otitis media serosa (OMS) en los niños menores de 5 años de la Comunidad Valenciana (España)

Sujetos y métodos

Cohorte retrospectiva de 1.399 niños seguidos durante los primeros 5 años de vida. Diecisiete pediatras revisaron las historias clínicas de sus pacientes nacidos en 1995 y 1996, controlados desde su nacimiento hasta los 5 años. Se obtuvo de cada niño el número de episodios de otitis, tratamiento, complicaciones e intervenciones quirúrgicas requeridas

Resultados

Hubo 2.961 episodios de OMA en los primeros 5 años de vida (2,23 casos/niño), 476 casos (16,1 %) antes del año y 1.346 entre el primer y segundo año (45,5 %). Al tercer año, el 59,8 % habían presentado al menos un episodio. La mayoría de casos (80,9 %) se diagnosticaron en atención primaria, con 1,81 visitas/episodio de media para su seguimiento. El 94,5% de los episodios fueron tratados con antibiótico (amoxicilina-ácido clavulánico 38,8 %, cefuroxima- axetilo, 14,3%; claritromicina, 8,2%, y amoxicilina 5,9 %). El 8,5 % requirió cambio a un segundo antibiótico. Presentaron al menos un episodio de OMS 217 niños (15,2 %). Necesitaron implantación de tubos de ventilación 26 pacientes (1,8 %, intervalo de confianza del 95 % (IC 95 %), 1,2–2,7). Presentaron hipoacusia secundaria 24 niños (1,7 %). Hubo un caso de meningitis y dos de otorrea crónica. No hubo mastoiditis

Conclusiones

La incidencia de OMA en la Comunidad Valenciana es de 40.014 episodios/100.000 niños menores de 5 años/año (IC 95 %, 39.700–40.300). Supone un gran impacto sanitario por el elevado número de visitas, uso antibiótico, cirugía asociada y necesidad de rehabilitación auditiva

Palabras clave:
Otitis media
Otitis media serosa
Epidemiología
Tratamiento farmacológico
Complicaciones
Tubos de ventilación
Objective

To assess the burden (incidence, treatment and complications) of acute otitis media (AOM) and otitis media with effusion (OME) in children younger than 5 years of age from Valencia, Spain

Subject and methods

We performed a retrospective cohort study of 1,399 children followed-up for the first 5 years of life. Seventeen pediatricians reviewed the medical records of their patients born in 1995 and 1996 and followed-up from birth until the age of 5 years. For each child, the number of otitis episodes, treatment, complications, and surgical interventions was obtained

Results

There were 2,961 episodes of AOM in the first 5 years of life (2.23 cases/child). Four hundred seventy-six cases (16.1 %) occurred before 1 year of age and 1,346 between the first and second year of life (45.5 %). By the third year of life, 59.8 % had had at least one episode. In most children (80.9 %), diagnosis was made in primary care and required a median of 1.81 visits/episode for follow-up. A total of 94.5 % were treated with antibiotics (amoxicillin- clavulanate 38.8%, cefuroxime 14.3 %, clarithromycin 8.2 % and amoxicillin 5.9 %) and 8.5 % required a change of antibiotic therapy. Two hundred seventeen children (15.2 %) had at least one episode of OME. Twenty-six patients (1.8 %, 95 % CI: 1.2–2.7 %) required insertion of ventilation tubes. Twenty-four patients (1.7 %) had secondary hypoacusis. There was one case of meningitis and two cases of chronic otorrhea. No cases of mastoiditis were recorded

Conclusions

The incidence of AOM in Valencia is 40,014 episodes/ 100,000 children younger than 5 years/year (95 % CI: 39,700–40,300). It represents a significant burden due to the large number of visits, antibiotic use, associated surgical procedures and need for auditory rehabilitation

Key words:
Otitis media
Otitis media with effusion
Epidemiology
Drug therapy
Complications
Middle ear ventilation tubes
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