Application of Evidence-Based Practice Guidelines in Acute Otitis Media

Acute Otitis Media

Acute otitis media is commonly diagnosed in patients who are experiencing middle ear effusion, inflammation in the middle year, pain, fever, and irritability. The pain associated with the complication is so much that often the patient becomes uncomfortable. In the given case, for example, the mother of the five-year-old boy explains that the boy is experiencing bilateral ear pain, and he has been crying so often due to pain. The mother adds that despite giving the boy ibuprofen, the pain does not seem to go away. On the contrary, the condition is even getting worse. To get good results, it is important that the medical practitioner makes use of the best evidence-based practice guideline (Vale, Claire, et al. 52). There are a number of evidence-based practice guidelines online but it is important that medical practitioners follow the current version. Current versions of the guideline are usually an improvement of the previous guideline.

Evidence-Based Practice Guideline

In this case, for example, the evidence-based practice guideline to be used was developed by the American Academy of Pediatrics (AAP). The guideline used is a revision of a previous guideline. AAP keeps on revising their previous guidelines in order to ensure that the guideline is as efficient as possible (Kitamura, Ken, et al. 102). They aim at achieving the best results and for this reason, they keep revising areas whereby they experienced some challenges. The guideline to be used was published on the 13th of April 2018. The guideline applies mainly to children between 6 months and 12 years. Based on the guideline, diagnosis of Acute Otitis media should be done in children who show moderate to severe swelling of the tympanic membrane, pain in the ear and mild swelling of the tympanic membrane (Robb, Peter, & Ian 10). The guideline warns that any child that does not show a case of middle ear effusion should not be diagnosed. In this case, the 5-year child presented by the parent is within the described year range and besides he feels pain in the ear.

Management of Acute Otitis Media

To manage the condition, the medical practitioner should begin by assessing the child pain and then recommend treatment to reduce the pain. In this case, it is important to avoid ibuprofen since the mother stated that it didn’t work previously. Besides this, the clinician should prescribe an antibiotic therapy. In this case, the mother already stated that the boy had no cases of antibiotic resistance. The tympanic temperature of the boy is already 103.2 degrees and hence he warrants an immediate antibiotic therapy (Steele, Dale, et al 32). Since the mother of the boy stated that the boy had not received any antibiotic for the past one year, then Amoxicillin can be administered. It is important that all prophylactic antibiotics should be avoided in order to reduce cases of the AOM recurring in the child. Adding on the prescription, the clinician can give tympanostomy tubes incase AOM recurs.

Research Studies and Quality of Evidence Guideline

While managing these particular guidelines, the AAP ensured that they conducted research studies in different hospitals to identify the efficiency of the previous guidelines (Rosenfeld, Richard et al 15). Thereafter, they identified some of the areas where the previous guidelines failed and then improved on those areas. The quality of the evidence guideline is defined based on the success of the treatment.

Recommendations and Key Action Statements

A strong recommendation is that which is meant to deal with a critical condition. A recommendation is meant to deal with a mild condition (Wallace, et al 300). Finally, an option is used by the clinician in case the strong recommendation of the recommendation does not function as expected.

Key action statements are driven by opportunities that are meant to offer the best practices, reduce the differences in care, and to reduce the utilization of resources (Fleming, Katherine, et al 1866). In this case, the key action statements are to offer the most affordable medications that are the most efficient such as amoxicillin. Besides, giving the drug that has the least chances of developing resistance and that which will reduce the chances of the disease from recurring.

Work cited

Fleming-Dutra, Katherine E., et al. “Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011.” Jama 315.17 (2016): 1864-1873.

Kitamura, Ken, et al. ”Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan–2013 update.” Auris Nasus Larynx 42.2 (2015): 99-106.

Robb, Peter J., and Ian Williamson. ”Otitis media with effusion in children: current management.” Pediatrics and Child Health 26.1 (2016): 9-14.

Rosenfeld, Richard M., et al. ”Clinical practice guideline: otitis media with effusion (update).” Otolaryngology-Head and Neck Surgery 154.1_suppl (2016): S1-S41.

Steele, Dale W., et al. ”Effectiveness of Tympanostomy tubes for otitis media: a meta-analysis.” Pediatrics 139.6 (2017): e20170125.

Vale, Claire L., et al. ”Uptake of systematic reviews and meta-analyses based on individual participant data in clinical practice guidelines: a descriptive study.” BMJ 350 (2015): h1088.

Wallace, Ina F., et al. ”Surgical treatments for otitis media with effusion: a systematic review.” Pediatrics 133.2 (2014): 296-311.