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Treatment failure, recurrence, and antibiotic prescription rates for different acute otitis media treatment methods.
Clin Pediatr (Phila) 2010; 49(10):970-5CPed

Abstract

In an era of increasing antibiotic resistance, reliance on empirical antibiotic therapy for management of acute otitis media (AOM) will eventually become an untenable strategy. New research efforts are needed to identify effective treatment alternatives. In this retrospective analysis, we assessed AOM treatment failure (AOMTF), recurrent AOM (RAOM), and antibiotic prescription rates for groups of AOM episodes managed with either immediate antibiotics (ABX), tympanocentesis + observation (Tap + OBS), or tympanocentesis + immediate antibiotics (Tap + ABX). No significant differences in rates of AOMTF or RAOM were observed between any of the treatment groups. The 30-day rate of antibiotic prescriptions written for AOM was significantly lower in the TAP + OBS group (1 prescription per 3.8 episodes) than in the immediate antibiotic therapy groups (1.2 prescriptions per episode), P < .001. The comparative risk of AOMTF was slightly higher among AOM episodes caused by Streptococcus pneumoniae (OR 2.523; CI 1.070-5.944; P = 0.056). Neither the presence of other particular otopathogens, nor the presence of drug-resistant otopathogens, nor the choice of any particular AOM antibiotic therapy correlated with increased risk of either AOMTF or RAOM. The observed absence of significant differences in clinical outcomes between the various treatment groups in this study is consistent with findings published by other authors: alternative AOM therapies can help reduce reliance on antibiotics without inviting significant increases in rates of clinical failure.

Authors+Show Affiliations

Woodcreek Healthcare Inc, Puyallup, WA 98371, USA. mgrubb@u.washington.eduNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20522607

Citation

Grubb, Mark S., and David C. Spaugh. "Treatment Failure, Recurrence, and Antibiotic Prescription Rates for Different Acute Otitis Media Treatment Methods." Clinical Pediatrics, vol. 49, no. 10, 2010, pp. 970-5.
Grubb MS, Spaugh DC. Treatment failure, recurrence, and antibiotic prescription rates for different acute otitis media treatment methods. Clin Pediatr (Phila). 2010;49(10):970-5.
Grubb, M. S., & Spaugh, D. C. (2010). Treatment failure, recurrence, and antibiotic prescription rates for different acute otitis media treatment methods. Clinical Pediatrics, 49(10), pp. 970-5. doi:10.1177/0009922810370363.
Grubb MS, Spaugh DC. Treatment Failure, Recurrence, and Antibiotic Prescription Rates for Different Acute Otitis Media Treatment Methods. Clin Pediatr (Phila). 2010;49(10):970-5. PubMed PMID: 20522607.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment failure, recurrence, and antibiotic prescription rates for different acute otitis media treatment methods. AU - Grubb,Mark S, AU - Spaugh,David C, Y1 - 2010/06/03/ PY - 2010/6/5/entrez PY - 2010/6/5/pubmed PY - 2011/1/22/medline SP - 970 EP - 5 JF - Clinical pediatrics JO - Clin Pediatr (Phila) VL - 49 IS - 10 N2 - In an era of increasing antibiotic resistance, reliance on empirical antibiotic therapy for management of acute otitis media (AOM) will eventually become an untenable strategy. New research efforts are needed to identify effective treatment alternatives. In this retrospective analysis, we assessed AOM treatment failure (AOMTF), recurrent AOM (RAOM), and antibiotic prescription rates for groups of AOM episodes managed with either immediate antibiotics (ABX), tympanocentesis + observation (Tap + OBS), or tympanocentesis + immediate antibiotics (Tap + ABX). No significant differences in rates of AOMTF or RAOM were observed between any of the treatment groups. The 30-day rate of antibiotic prescriptions written for AOM was significantly lower in the TAP + OBS group (1 prescription per 3.8 episodes) than in the immediate antibiotic therapy groups (1.2 prescriptions per episode), P < .001. The comparative risk of AOMTF was slightly higher among AOM episodes caused by Streptococcus pneumoniae (OR 2.523; CI 1.070-5.944; P = 0.056). Neither the presence of other particular otopathogens, nor the presence of drug-resistant otopathogens, nor the choice of any particular AOM antibiotic therapy correlated with increased risk of either AOMTF or RAOM. The observed absence of significant differences in clinical outcomes between the various treatment groups in this study is consistent with findings published by other authors: alternative AOM therapies can help reduce reliance on antibiotics without inviting significant increases in rates of clinical failure. SN - 1938-2707 UR - https://www.unboundmedicine.com/medline/citation/20522607/Treatment_failure_recurrence_and_antibiotic_prescription_rates_for_different_acute_otitis_media_treatment_methods_ L2 - http://journals.sagepub.com/doi/full/10.1177/0009922810370363?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -