الفهرس 
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Abstract
During the last decade the number of published guidelines has rapidly increased. Awareness of and adherence to evidence based clinical guidelines is considered vital for improving effectiveness, quality and safety of patient care.
The aim of this study is to assess the adherence of different specialties (family physicians, pediatricians and otolaryngologists) to different published guidelines dealing with acute otitis media.The study was descriptive analytical study .the study sample was collected during different conferences in the faculty of medicine at Menoufia University during 2014-2015.They were from different departments (family physicians, pediatricians and otolaryngologists).They were selected by systematic random techniques from the list of attendance. Questionnaire distributed to physicians to assess their adherence to acute otitis media guidelines.
The study revealed that there was no statistically significant differences between different specialties regarding their adherence to different guidelines in which 52.1% of otolaryngologists were poor adhered to acute otitis media guidelines while 47.2% of family physicians were poor adhered to acute otitis media guidelines. Moreover, 68.6% of pediatricians were poor adhered to these guidelines. The reasons of non-adherence to the guidelines are explained by Mark 2011, as it may be due to physician inertia and culture, lack of appropriate incentives, lack of detailed knowledge due to poor dissemination, conflict of interest, parental pressure, and insufficient use of appropriate analgesia, uncertain diagnosis, and concerns over possible complication from not treating infection.
The British guideline was the most commonly adhered guideline among all the seven guidelines investigated, especially among the family physicians. Moreover, the present study’s results reflected that the age and experience as a variable did not significantly affect the adherence of different specialties to different guidelines.
The total percentage of antibiotics prescription from different specialties dealing with mild AOM was 69.3%. This may be explained as most physicians used antibiotics as prophylactic attitude to prevent complication such as mastoiditis, and that viral infection of acute otitis media does not rule–out bacterial.