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Delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary care.
Arch Pediatr Adolesc Med 2005; 159(7):679-84AP

Abstract

OBJECTIVES

To evaluate the applicability and the effectiveness of practice guidelines based on a wait-and-see strategy for children with acute otitis media (AOM).

POPULATION

Children from 1 to 14 years old having AOM who were referred to primary care pediatric practices.

STUDY DESIGN

Prospective observational study.

MAIN OUTCOME MEASURE

Proportion of children having a diagnosis of AOM and eligible for symptomatic treatment who, at 72 hours from enrollment, recovered from their symptoms (fever and earache) without receiving antibiotic treatment.

RESULTS

One hundred sixty-nine pediatricians participated in the study and enrolled 1672 children. One thousand two hundred seventy-seven children were included in the analysis. One hundred seventy-eight children received antibiotic treatment at first contact according to the practice guidelines criteria (presence of otorrhea or recurrent AOM). Of the 1099 children who were eligible for symptomatic treatment only, 743 (67.6%) recovered without antibiotic treatment at 3 days and 716 (65.1%) at 30 days. No complications were observed. Coexistence of a high fever (temperature > or = 38.4 degrees C) and red and bulging tympanic membrane as well as male sex were significantly associated with antibiotic use.

CONCLUSIONS

Practice guidelines based on a wait-and-see strategy for children with AOM are applicable and effective in primary care. This strategy was able to avoid the administration of antibiotic treatment in 2 of 3 children.

Authors+Show Affiliations

Department of Pediatrics and Epidemiology Unit, Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15997003

Citation

Marchetti, Federico, et al. "Delayed Prescription May Reduce the Use of Antibiotics for Acute Otitis Media: a Prospective Observational Study in Primary Care." Archives of Pediatrics & Adolescent Medicine, vol. 159, no. 7, 2005, pp. 679-84.
Marchetti F, Ronfani L, Nibali SC, et al. Delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary care. Arch Pediatr Adolesc Med. 2005;159(7):679-84.
Marchetti, F., Ronfani, L., Nibali, S. C., & Tamburlini, G. (2005). Delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary care. Archives of Pediatrics & Adolescent Medicine, 159(7), pp. 679-84.
Marchetti F, et al. Delayed Prescription May Reduce the Use of Antibiotics for Acute Otitis Media: a Prospective Observational Study in Primary Care. Arch Pediatr Adolesc Med. 2005;159(7):679-84. PubMed PMID: 15997003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary care. AU - Marchetti,Federico, AU - Ronfani,Luca, AU - Nibali,Sergio Conti, AU - Tamburlini,Giorgio, AU - ,, PY - 2005/7/6/pubmed PY - 2005/8/12/medline PY - 2005/7/6/entrez SP - 679 EP - 84 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 159 IS - 7 N2 - OBJECTIVES: To evaluate the applicability and the effectiveness of practice guidelines based on a wait-and-see strategy for children with acute otitis media (AOM). POPULATION: Children from 1 to 14 years old having AOM who were referred to primary care pediatric practices. STUDY DESIGN: Prospective observational study. MAIN OUTCOME MEASURE: Proportion of children having a diagnosis of AOM and eligible for symptomatic treatment who, at 72 hours from enrollment, recovered from their symptoms (fever and earache) without receiving antibiotic treatment. RESULTS: One hundred sixty-nine pediatricians participated in the study and enrolled 1672 children. One thousand two hundred seventy-seven children were included in the analysis. One hundred seventy-eight children received antibiotic treatment at first contact according to the practice guidelines criteria (presence of otorrhea or recurrent AOM). Of the 1099 children who were eligible for symptomatic treatment only, 743 (67.6%) recovered without antibiotic treatment at 3 days and 716 (65.1%) at 30 days. No complications were observed. Coexistence of a high fever (temperature > or = 38.4 degrees C) and red and bulging tympanic membrane as well as male sex were significantly associated with antibiotic use. CONCLUSIONS: Practice guidelines based on a wait-and-see strategy for children with AOM are applicable and effective in primary care. This strategy was able to avoid the administration of antibiotic treatment in 2 of 3 children. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/15997003/Delayed_prescription_may_reduce_the_use_of_antibiotics_for_acute_otitis_media:_a_prospective_observational_study_in_primary_care_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.159.7.679 DB - PRIME DP - Unbound Medicine ER -