CHAPTER 45 ACUTE OTITIS MEDIA AND DELAYED ANTIBIOTIC TREATMENT

Wait-and-see Prescription for the Treatment of Acute Otitis Media: A Randomized Controlled Trial

Spiro DM, Tay KY, Arnold DH, Dziura JD, Baker MD, Shapiro ED. JAMA. 2006;296(10):1235–1241

BACKGROUND

Acute otitis media (AOM) is one of the most frequent pediatric ED diagnoses leading to an estimated 15 million antibiotic prescriptions a year. Usually triggered by a viral illness, the middle ear effusions of AOM often contain bacteria isolates and can lead to complications, such as mastoiditis. Despite this, a large number of AOM will resolve spontaneously. Prior studies had specifically excluded children with severe otitis media and those with fevers and were convenience samples leaving uncertainty regarding how effective an antibiotic-optional approach would work. Given the complications associated with antibiotic use (including allergy, bacterial resistance, and diarrhea), it was posited that the number of infections treated with antibiotics could be reduced using a wait-and-see approach.

OBJECTIVES

To determine whether treatment of AOM using a wait-and-see prescription approach would reduce the use of antibiotics and to evaluate the impact of this intervention on clinical symptoms and adverse outcomes.

METHODS

Related posts:

Oral vs. IV Rehydration Spontaneous Ureteral Stone Passage Heparinizing Unstable Angina Amiodarone in Ventricular Fibrillation Bicarbonate Therapy in DKA Risk of Serious Bacterial Infection in Febrile Infants with RSV

Stay updated, free articles. Join our Telegram channel

Join