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Delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary care.

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.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics and Epidemiology Unit, Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy.

    , , ,

    Source

    MeSH

    Acute Disease
    Adolescent
    Anti-Bacterial Agents
    Child
    Child, Preschool
    Drug Prescriptions
    Female
    Follow-Up Studies
    Humans
    Infant
    Infant, Newborn
    Male
    Observation
    Otitis Media
    Primary Health Care
    Prospective Studies
    Time Factors

    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/full_citation L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.159.7.679 DB - PRIME DP - Unbound Medicine ER -