Care for Acute Otitis Media in Children by General Practitioners in North Benin in 2017

Abstract

Introduction: Acute otitis media (AOM) is a common childhood infection, subject to a wrongful prescription of antibiotics. The objective of this work was to evaluate the practices of general practitioners of North-Benin, in term of caring AOM in children. Methods: This was a cross-sectional, descriptive survey based on a telephone interview questionnaire with 112 general practitioners working in North Benin in 2017. The collected data were analyzed using EpiData Analysis and Open Epi software. The Khi2 test was used for comparisons. The significance threshold adopted was 0.05. Results: Of the 145 general practitioners listed, 112 participated in the survey for a participation rate of 77.2%. The mean age was 32 ± 6 years with a sex ratio of 4.04 and the median duration of seniority in the medical practice was 4 years with extremes of 1 and 32 years. Three main clinical signs suggestive of the diagnosis were, according to the respondents, otalgia (107; 95.5%), otorrhea (86; 76.8%) and fever (77; 68.8%). Tympanum inflammation and middle ear effusion association was considered as a diagnostic criterium by 17.9% of doctors. Therapeutic recommendations were known by 15 doctors (13.4%). Systematic antibiotic therapy was advocated by 86 doctors (76.8%). The main reasons for systematic antibiotics were the frequent use of antibiotics by parents in the self-medication (63 cases or 74.4%), the difficulty of following up the child (55 cases or 64 per cent) and the fear of the locoregional or systemic spread of infection (40 cases or 46.5%). The amoxicillin-clavulanic acid combination was prescribed as first-line by 68 respondents (62.4%). Forty doctors (36.7%) prescribed third-generation cephalosporins as second-line therapy. Systemic rhinopharyngeal disinfection was performed by 23 doctors (20.5%). In case of therapeutic failure, the opinion of an ENT doctor was requested by 66 general practitioners or 58.9% of the cases. Conclusion: It is necessary that Beninese medical companies develop national recommendations for managing the acute otitis media and ensure their diffusion through continuous medical training.