Abstract
Objective: Our aim in this study is to analyze the compliance rates with current guidelines by raising awareness among pediatricians, otolaryngologists, general practitioners and family physicians about the diagnosis and treatment of acute bacterial rhinosinusitis.
Methods: A survey containing 18 questions was sent to physicians working in the Marmara Region of Turkey. The responses and variables, including age, gender, duration of professional experience, specialty area, and the number of cases diagnosed in one month, were evaluated concerning the current guidelines from the American Society of Infectious Diseases
Results: Totally 500 physicians were enrolled into this study. The majority of the physicians participating in the study [91,4% (n=458)] did not know how to differentiate acute rhinosinusitis from viral upper respiratory tract infection clinically. The number of physicians prescribing the correct antibiotic but at the wrong dosage was 186 (37.2%). It was observed that general physicians made more mistakes in determining the diagnosis with the correct criteria than the other specialties (p=0.03).
Conclusion: There appears to be a problem of clinical inertia in the diagnosis and treatment of pediatric acute bacterial rhinosinusitis at the emergency department in Turkey, possibly due to unfamiliarity with the condition, patient overload, worries about performance fees, and failure to update medical knowledge concerning current guidelines. Increased emphasis on continuing professional education and various supportive measures for primary care physicians may help to resolve this.
References
- Gwaltney JM Jr. Acute community-acquired sinusitis. Clin Infect Dis. 1996;23:1209-122.
- Chow AW, Benninger MS, Brook I et al. Clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012; 54(8):1041–1045.
- Slavin RG. Nasal polyps and sinusitis. JAMA. 1997;278:1849-54.
- Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015;109(7):309.
- Dadgostar P. Antimicrobial resistance: implications and costs. Infect Drug Resist. 2019;12:3903–3910.
- Kılıçaslan İ, Bozan H, Oktay C et al. Demographic properties of patients presenting to the emergency department in Turkey. Turk J Emerg Med. 2005; 5(1): 5-13.
- Liadova AV, Korkiya ED, Mamedov AK, et al. The burnout among emergency physicians: Evidence from Russia (sociological study). Man in India. 2017;97(15):495–507.
- Aring AM, Chan MM. Acute rhinosinusitis in adults. Am Fam Physician. 2011;83(9):1057–1063.
- Gumussoy M, Ugur O, Arslan IB et al. Orbital Complications of Acute Sinusitis Evaluation, Management, and Results. Turk Arch Otorhinolarigol. 2014;52(4):131–138.
- Andrade C. The Limitations of Online Surveys. Indian J Psycho Med. 2020;42(6):575–576.
Abstract
Amaç: Çalışmamızdaki amaç çocuk sağlığı ve hastalıkları uzmanları, kulak burun boğaz uzmanları, pratisyen hekimler ve aile hekimleri arasında akut bakteriyel rinosinüzit tanı ve tedavisi konusunda farkındalık yaratarak güncel kılavuzlara uyum oranlarını analiz etmektir.
Yöntem: Marmara Bölgesi'nde görev yapan hekimlere 18 sorudan oluşan bir anket gönderilmiştir. Yaş, cinsiyet, mesleki deneyim süresi, uzmanlık alanı ve bir ay içinde teşhis edilen vaka sayısı gibi yanıtlar ve değişkenler, Amerikan Enfeksiyon Hastalıkları Derneği'nin güncel kılavuzlarına göre değerlendirildi.
Bulgular: Bu çalışmaya toplam 500 hekim katıldı. Hekimlerin çoğunluğunun [91,4% (n=458)] akut rinosinüziti viral üst solunum yolu enfeksiyonundan klinik olarak nasıl ayırt edeceklerini bilmediği gözlemlendi. Doğru antibiyotiği yanlış dozda reçete eden hekim sayısı 186 (%37,2) idi. Pratisyen hekimlerin diğer branşlara göre doğru kriterlerle tanı koymada daha fazla hata yaptıkları görüldü (p=0,03).
Sonuç: Türkiye'de acil serviste pediatrik akut bakteriyel rinosinüzit tanı ve tedavisinde, muhtemelen duruma aşina olmama, aşırı hasta yükü, performans ücretleriyle ilgili endişeler ve mevcut kılavuzlarla ilgili tıbbi bilgilerin güncellenmemesi nedeniyle klinik atalet sorunu olduğu görülmektedir. Sürekli mesleki eğitime artan vurgu ve birinci basamak hekimleri için çeşitli destekleyici önlemler bu sorunu çözmeye yardımcı olabilir.
Keywords
References
- Gwaltney JM Jr. Acute community-acquired sinusitis. Clin Infect Dis. 1996;23:1209-122.
- Chow AW, Benninger MS, Brook I et al. Clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012; 54(8):1041–1045.
- Slavin RG. Nasal polyps and sinusitis. JAMA. 1997;278:1849-54.
- Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015;109(7):309.
- Dadgostar P. Antimicrobial resistance: implications and costs. Infect Drug Resist. 2019;12:3903–3910.
- Kılıçaslan İ, Bozan H, Oktay C et al. Demographic properties of patients presenting to the emergency department in Turkey. Turk J Emerg Med. 2005; 5(1): 5-13.
- Liadova AV, Korkiya ED, Mamedov AK, et al. The burnout among emergency physicians: Evidence from Russia (sociological study). Man in India. 2017;97(15):495–507.
- Aring AM, Chan MM. Acute rhinosinusitis in adults. Am Fam Physician. 2011;83(9):1057–1063.
- Gumussoy M, Ugur O, Arslan IB et al. Orbital Complications of Acute Sinusitis Evaluation, Management, and Results. Turk Arch Otorhinolarigol. 2014;52(4):131–138.
- Andrade C. The Limitations of Online Surveys. Indian J Psycho Med. 2020;42(6):575–576.
Details
| Primary Language | English |
|---|---|
| Subjects | Paediatrics |
| Journal Section | Original Article / Medical Sciences |
| Authors | |
| Publication Date | February 2, 2023 |
| Submission Date | October 5, 2022 |
| Acceptance Date | December 15, 2022 |
| Published in Issue | Year 2023 Volume: 9 Issue: 1 |
