Antibiotics for nasopharyngitis are associated with a lower risk of office-based physician visit for acute otitis media within 14 days for 3- to 6-year-old children

Short-term and long-term effects of PM2.5 on acute nasopharyngitis in 10 communities of Guangdong, China

OBJECTIVES

We aimed to assess the effects of short-term and long-term exposure to ambient fine particle matter (PM_2.5) on acute nasopharyngitis.

METHODS

A total of 9468 participants aged 18 years and above were recruited from 10 communities in four cities of Guangdong, China during the baseline survey in 2014, and they were followed-up from January 2015 to December 2016. Air pollution exposure was assessed based on the daily concentrations (short-term) and annual concentrations (long-term) of the nearby air monitoring station and the survey date. A mixed-effect logistic model and Cox proportional hazards model were used to quantify the short-term and long-term associations after adjustment for potential confounding factors.

RESULTS

Significantly positive associations were found between both short-term and long-term exposures of PM_2.5 and acute nasopharyngitis. The adjusted odds ratio was 1.15 (95% CI: 1.07, 1.23) for each 10 μg/m³ increase in daily PM_2.5 at lag2 day (short-term effects), and the hazard risk was 1.18 (95% CI: 1.10, 1.25) for each 10 μg/m³ increase in annual PM_2.5 (long-term effects). Stronger associations between short-term PM_2.5 exposure and acute nasopharyngitis were observed among men (OR = 1.10; 95% CI: 1.04, 1.17) and participants aged above 65 years (OR = 1.13; 95% CI: 1.04, 1.23) in the stratified analyses. No significant association was found in women (OR = 1.00; 95% CI: 0.92, 1.10) or young participants ≤65 years (OR = 0.96; 95% CI: 0.88, 1.04). However, for the long-term exposure, the hazard risk was higher for participants younger than 65 years (OR = 1.22; 95% CI: 1.12, 1.32) than the older group (OR = 1.11; 95% CI: 1.00, 1.24).

CONCLUSION

This study indicates that both short-term and long-term exposures to higher concentrations of PM_2.5 could increase the risk of acute nasopharyngitis.

Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Children with acute respiratory or ear infections (RTI/OM) are often unnecessarily prescribed antibiotics. Antibiotic resistance is a major public health problem and antibiotic prescription for RTI/OM should be reduced. Anthroposophic treatment of RTI/OM includes anthroposophic medications, nonmedication therapy and if necessary also antibiotics. This secondary analysis from an observational study comprised 529 children <18 years from Europe (AT, DE, NL, and UK) or USA, whose caregivers had chosen to consult physicians offering anthroposophic (A-) or conventional (C-) treatment for RTI/OM. During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 25.6% of C-patients (P < 0.001); unadjusted odds ratio for nonprescription in A- versus C-patients 6.58 (95%-CI 3.45–12.56); after adjustment for demographics and morbidity 6.33 (3.17–12.64). Antibiotic prescription rates in recent observational studies with similar patients in similar settings, ranged from 31.0% to 84.1%. Compared to C-patients, A-patients also had much lower use of analgesics, somewhat quicker symptom resolution, and higher caregiver satisfaction. Adverse drug reactions were infrequent (2.3% in both groups) and not serious. Limitation was that results apply to children of caregivers who consult A-physicians. One cannot infer to what extent antibiotics might be avoided in children who usually receive C-treatment, if they were offered A-treatment.

Panel 1: Epidemiology, natural history, and risk factors

BACKGROUND

The First International Symposium on Recent Advances in Otitis Media (OM) with Effusion was held in Columbus, Ohio, in 1975. The symposium has been organized in the United States every 4 years since, followed by a research conference to (a) assess major research accomplishments, (b) identify important research questions and opportunities, (c) develop consensus on definitions and terminology, and (d) establish priorities with short- and long-term research goals. One of the principal areas reviewed quadrennially is Epidemiology, Natural History, and Risk Factors.

OBJECTIVE

To provide a review of recent literature on the epidemiology, natural history, and risk factors for OM.

DATA SOURCES AND REVIEW METHODS

A search of OM articles in English published July 2007 to June 2011 was conducted using PubMed and related databases. Those with findings judged of importance for epidemiology, public health, and/or statistical methods were reviewed.

RESULTS

The literature has continued to expand, increasing understanding of the worldwide burden of OM in childhood, complications from treatment failures, and comorbidities. Novel risk factors, including genetic factors, have been examined for OM susceptibility. Population-based studies in Canada, the United States, and other countries confirmed reductions in OM prevalence. Although most studies concentrated on acute OM (AOM) or OM with effusion (OME), a few examined severe chronic suppurative OM (CSOM), a major public health problem in developing countries and for certain indigenous populations around the world.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Recent publications have reinforced earlier epidemiological findings, while extending our knowledge in human population groups with high burden of OM.