Linee guida
La faringotonsillite e l’otite media acuta in etŕ pediatrica. La guida rapida sviluppata dalla Regione Emilia-Romagna
SORE THROAT AND ACUTE OTITIS MEDIA IN CHILDREN: A POCKET GUIDELINE PRODUCED BY THE EMILIA-ROMAGNA REGION
SIMONA DI MARIO1, CARLO GAGLIOTTI2, MARA ASCIANO3, MARIALUISA MORO2 PER IL COMITATO TECNICO SCIENTIFICO REGIONALE DEI PEDIATRI “PROGETTO PROBA-II FASE”*
1 CeVEAS, Azienda USL di Modena e Agenzia Sanitaria Regionale Emilia-Romagna, Area Rischio Infettivo
2 Agenzia Sanitaria Regionale Emilia-Romagna, Area Rischio Infettivo
3 Pediatria di comunitŕ, Azienda USL di Rimini e Agenzia Sanitaria Regionale Emilia-Romagna, Area Rischio Infettivo
Gennaio 2008 - pagg. 38 -42
Abstract
The regional ProBA project conducted in Emilia-Romagna aims at assessing the determinants
of antibiotic prescriptions in children and at promoting appropriate use of antibiotic for upper
respiratory infections. During the first phase of the ProBA project the following priorities for action
were identified: a) facilitating communications between parents and paediatricians, through
informative materials developed ad hoc on acute respiratory infections in children and the
correct use of antibiotics; b) improving the management of sore throat and acute otitis media
in children through the development of guidelines along with instruments for their implementation
(decision aids, rapid diagnostic tests, audit and feedback of antimicrobial usage, training
courses). The guidelines were developed according to the international GRADE system that aims
at building a transparent and clear process for the attribution of the strengths of the recommendations,
and contain a summary of the recommendations, diagnostic and therapeutic algorithms
and tables of evidence plus instruments for guidelines implementation. The guidelines
are provided to professionals in two formats: the full guideline and a pocket summary version
for prompt consultation, which is presented here.
Parole chiave
Classificazione MeSH
Bibliografia
1. Milandri M, Marchi M, Resi D, Moro ML.
ProBA Progetto Bambini e antibiotici. I determinanti
della prescrizione nelle infezioni delle
alte vie respiratorie. Collana Dossier, n. 115,
Regione Emilia-Romagna - ASR, 2005.
2. Ehrlich JE, Demopoulos BP, Daniel KR Jr, Ricarte MC, Glied S. Cost-effectiveness of treatment options for prevention of rheumatic heart disease from group A streptococcal pharyngitis in a pediatric population. Prev Med 2002;35:250-7.
3. Gagliotti C, Nobilio L, Milandri M, Moro ML. Emilia-Romagna Antibiotic Resistance Study Group. Macrolide prescriptions and erythromycin resistance of Streptococcus pyogenes. Clin Infect Dis 2006b;42:1153-6.
4. Nasrin D, Collignon PJ, Roberts L, Wilson EJ, Pilotto LS, Douglas RM. Effect of beta-lactam antibiotic use in children on pneumococcal resistance to penicillin: prospective cohort study. BMJ 2002;324:28-30.
5. Bergman M, Huikko S, Pihlajamäki M, et al.; Finnish Study Group for Antimicrobial Resistance (FiRe Network). Effect of macrolide consumption on erythromycin resistance in Streptococcus pyogenes in Finland in 1997-2001. Clin Infect Dis 2004;38:1251-6.
6. Bonati M. Progetto ARNO-Osservatorio sulla prescrizione farmaceutica pediatrica. Rapporto
2003. Il profilo prescrittivo della popolazione pediatrica italiana nelle cure primarie. Monografia di Ricerca & Pratica, n. 6. Roma: Il Pensiero Scientifico Editore, novembre 2004.
7. Little P, Gould C, Williamson I, Warner G, Gantley M, Kinmonth AL. Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ 1997;315:350-2.
8. Marra F, Monnet DL, Patrick DM, et al. A comparison of antibiotic use in children between Canada and Denmark. Ann Pharmacother 2007;41(4):659-66.
9. Blondel-Hill E, Fryters S, Mitchell S, Tomney M, Wilson D, Carson M. Do Bugs Need Drugs? A community project for the wise use of antibiotics [Abstract L-2064]. In: Abstracts of the 41st Annual Interscience Conference on Antimicrobial Agents and Chemotherapy; December 16-19/2001; Chicago (IL), USA. Washington, DC: American Society for Microbiology, 2001:476.
10. Gagliotti C, Buttazzi R, Nobilio L, Tomesani A, Alboresi S, Moro ML. Uso di antibiotici sistemici e resistenze antibiotiche nella popolazione pediatrica dell’Emilia-Romagna. Rapporto. Bologna, Agenzia sanitaria regionale dell’Emilia- Romagna, ottobre 2006a. Disponibile all’URL http://asr.regione.emilia-romagna.it/ wcm/asr/aree_di_programma/rischioinfettivo/ gr_ric/pr_antibres/stpr_sorve_usoantib/ pubblicazioni/antibiotici_pediatria/link/a ntibiotici_pediatria.pdf (file pdf, 131 Kb - ultimo accesso 25/9/2007).
11. Khan KS, Coomarasamy A. Searching for evidence to inform clinical practice. Current Obstetrics & Gynaecology 2004;14:142-6.
12. Guyatt G, Gutterman D, Baumann MH, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American college of chest physicians task force. Chest 2006;129:174-81.
2. Ehrlich JE, Demopoulos BP, Daniel KR Jr, Ricarte MC, Glied S. Cost-effectiveness of treatment options for prevention of rheumatic heart disease from group A streptococcal pharyngitis in a pediatric population. Prev Med 2002;35:250-7.
3. Gagliotti C, Nobilio L, Milandri M, Moro ML. Emilia-Romagna Antibiotic Resistance Study Group. Macrolide prescriptions and erythromycin resistance of Streptococcus pyogenes. Clin Infect Dis 2006b;42:1153-6.
4. Nasrin D, Collignon PJ, Roberts L, Wilson EJ, Pilotto LS, Douglas RM. Effect of beta-lactam antibiotic use in children on pneumococcal resistance to penicillin: prospective cohort study. BMJ 2002;324:28-30.
5. Bergman M, Huikko S, Pihlajamäki M, et al.; Finnish Study Group for Antimicrobial Resistance (FiRe Network). Effect of macrolide consumption on erythromycin resistance in Streptococcus pyogenes in Finland in 1997-2001. Clin Infect Dis 2004;38:1251-6.
6. Bonati M. Progetto ARNO-Osservatorio sulla prescrizione farmaceutica pediatrica. Rapporto
2003. Il profilo prescrittivo della popolazione pediatrica italiana nelle cure primarie. Monografia di Ricerca & Pratica, n. 6. Roma: Il Pensiero Scientifico Editore, novembre 2004.
7. Little P, Gould C, Williamson I, Warner G, Gantley M, Kinmonth AL. Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ 1997;315:350-2.
8. Marra F, Monnet DL, Patrick DM, et al. A comparison of antibiotic use in children between Canada and Denmark. Ann Pharmacother 2007;41(4):659-66.
9. Blondel-Hill E, Fryters S, Mitchell S, Tomney M, Wilson D, Carson M. Do Bugs Need Drugs? A community project for the wise use of antibiotics [Abstract L-2064]. In: Abstracts of the 41st Annual Interscience Conference on Antimicrobial Agents and Chemotherapy; December 16-19/2001; Chicago (IL), USA. Washington, DC: American Society for Microbiology, 2001:476.
10. Gagliotti C, Buttazzi R, Nobilio L, Tomesani A, Alboresi S, Moro ML. Uso di antibiotici sistemici e resistenze antibiotiche nella popolazione pediatrica dell’Emilia-Romagna. Rapporto. Bologna, Agenzia sanitaria regionale dell’Emilia- Romagna, ottobre 2006a. Disponibile all’URL http://asr.regione.emilia-romagna.it/ wcm/asr/aree_di_programma/rischioinfettivo/ gr_ric/pr_antibres/stpr_sorve_usoantib/ pubblicazioni/antibiotici_pediatria/link/a ntibiotici_pediatria.pdf (file pdf, 131 Kb - ultimo accesso 25/9/2007).
11. Khan KS, Coomarasamy A. Searching for evidence to inform clinical practice. Current Obstetrics & Gynaecology 2004;14:142-6.
12. Guyatt G, Gutterman D, Baumann MH, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American college of chest physicians task force. Chest 2006;129:174-81.
Corrispondenza: s.dimario@ausl.mo.it