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Master Thesis

Déterminants cliniques de la prescription antibiotique dans l’otite moyenne aiguë de l’enfant et de l’adulte en médecine générale

Abstract : Introduction : Resistance of bacterias to antibiotics represents a major public health issue and requires a rational use of antibiotics to fight this real danger. The aim of our study was to clarify the clinical determinants of the antibiotic prescription in acute otitis media in general practice and to analyse the quality of the antibiotic prescription (molecule choice, posology, length of treatment). Patients and methods : we started from a prospective investigation on the upcoming event AOM seen in consultation. Two physician groups are studied and compared : on one hand, the general practitioners from Aquitaine watched by their resident (group 1), and on the other hand, the substitute general practitioners group (group 2). A form was sent to both groups. Results : Forty eight general practitioners in group 1 and 95 in group 2 are included. Fever, intensity of pain and bulging tympanic membrane were the main factors influencing antibiotic prescription. Severe earache, fever above 39°C, and otorrhoea appeared as factors of systematic antibiotic prescription. This study shows that 60% and 68% of congestive eardrums at otoscopy, respectively in groups 1 and 2 received antibiotherapy. Amoxicillin is the most prescribed molecule in both groups. Respectively 45 and 22% of the prescriptions, in groups 1 and 2, are under recommended posology. Conclusion : The antibiotic prescription in AOM, influenced by some clinical elements of seriousness, is too often not justified. A better education of general practitioners and patients on the benignity of AOM could decrease antibiotic prescriptions.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01214025
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Submitted on : Friday, October 9, 2015 - 3:49:10 PM
Last modification on : Wednesday, August 23, 2017 - 4:31:52 PM
Long-term archiving on: : Sunday, January 10, 2016 - 10:31:23 AM

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Étienne Soubran. Déterminants cliniques de la prescription antibiotique dans l’otite moyenne aiguë de l’enfant et de l’adulte en médecine générale. Médecine humaine et pathologie. 2015. ⟨dumas-01214025⟩

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