Acute otitis media and its prevention by immunization A survey of canadian paediatricians' knowledge, attitudes and beliefs

Introduction: Acute otitis media (AOM) is one of the most common bacterial infectious diseases among children and is a leading cause of child healthcare visits and antibiotic prescriptions. Few vaccines have the potential to prevent AOM. The newer pneumococcal conjugate vaccines (PC V) offer a larger spectrum of protection against AOM, as well as preventing severe diseases. The main aim of this study was to assess paediatricians' opinions regarding AOM and its prevention by immunization. Results: Response rate was 50%. Around 60% of respondents estimated that more than 50% of their patients under the age of 3 years would suffer from at least one episode of AOM in the following year. Most respondents (79%) rated consequences of AOM as moderate. Almost all physicians (99%) considered the newer PC V as safe and effective. Most respondents considered their knowledge of the new vaccines was sufficient. More than 90% had a firm intention to recommend newer PC V to their patients. Perceived benefits of AOM prevention by immunization were: reduction of antibiotic administration and reduction of post-AOM complications. More than half of respondents (53%) considered the risk of adverse events as a barrier to AOM prevention by immunization. In multivariate analysis, the main determinant of paediatricians' intention to recommend newer PC V was perceived safety and efficacy of the vaccines (partial R-2 = 0.40, p < 0.0001). Discussion: Results of this survey show that AOM is perceived as an important health problem by paediatricians. Information about the increased protection against AOM offered by newer PC V should be disseminated to physicians. Materials and Methods: A self-administered, anonymous, mail-based questionnaire based upon the Health Belief Model and the Analytical framework for immunization programs was sent to all 1,852 Canadian paediatricians.