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• W2890219306 abstract "Tapping into the nationally representative databases from the National Center for Health Statistics at the US Centers for Disease Control and Prevention, Kawai et al from Boston queried the number of otitis media associated ambulatory visits in children up to 18 years of age over the years 1997 to 2014. This interval spans years before universal use of pneumococcal conjugate vaccine (PCV) (before 2000), during PCV7 use, and since PCV13 use beginning in late 2010 in children 2 months through 59 months of age. A strength of the study is that the databases include 3 types of ambulatory physician visits: in office practices, hospital-associated outpatient departments, and emergency departments. The results are only broad brush strokes as no attempt was made to assess criteria or providers' clinical acumen to diagnose/code otitis media, whether visits were at the time of diagnosis or for follow up, and did not take in to account changing national recommendations for management that included dropping follow up visits for uncomplicated acute otitis media. The results, however, represent real world incidence and are in line with smaller (less representative samples) that did include more granular data. Almost 25 000 otitis media related visits were identified over the study period. Between the pre-PCV7 and post-PCV13 period, annual physician office visits for those under 2 years of age declined most dramatically (ie, by 51%, CI 42% to 58%; from 826 to 387 visits per 1000 children under 2 years of age). Declines occurred across all ambulatory settings. An equally important finding was decline across demographics of sex, race/ethnicity, age, health insurance status, and across geographic regions. Without debate, PCV7 and PCV13 have all but eliminated the primary “bad actor” pneumococci of previous severe infection that led to the most “problematic” cases as well as protracted middle ear inflammation that facilitated recurrent episodes of acute otitis media. PCVs also have all but eliminated dread pneumococcal invasion of the bloodstream and central nervous system. With these helpful data from Kawai et al in mind, providers should have greatly reduced prescribing of antibiotics in ambulatory settings and parents should expect receiving many fewer prescriptions. Article page 122 ▶ Ambulatory Visits for Otitis Media before and after the Introduction of Pneumococcal Conjugate VaccinationThe Journal of PediatricsVol. 201PreviewTo examine the long-term trend of otitis media (OM)-associated ambulatory visits from 1997 to 2014 and to evaluate the impact of 7-valent and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) on OM ambulatory visits. Full-Text PDF" @default.
• W2890219306 created "2018-09-27" @default.
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• W2890219306 date "2018-10-01" @default.
• W2890219306 modified "2023-09-25" @default.
• W2890219306 title "Decline in otitis media associated ambulatory visits in the US" @default.
• W2890219306 doi "https://doi.org/10.1016/j.jpeds.2018.07.108" @default.
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