Growing pertain to about antibioti...

Growing pertain to about antibiotic resistance and the small benefit of treating acute otitis media (AOM) with antibiotics have made initial observation an attractive treatment option in children with ear infections. However, parents many times want antibiotics for their children and believe that antibiotic treatment is necessary for ear infections. A physician in England implemented the conception of a safety-net antibiotic prescription (SNAP). Parents were given an antibiotic prescription still were asked not to fill it unles the child's symptoms persisted for a day or more. Using this strategy, the physician was able to lower the total number of antibiotics used according to his patients by 20 percent Siegel and colleagues mannersed a study to determine the acceptability of a SNAP policy in a multicenter pediatric research cluster in Cincinnati, Ohio.

Children single through 12 years of age with otitis media were enlisted in the study. Exclusion criteria related to greater severity of disease or perceived question s with follow-up. Parents were instructed not to fill the SNAP unles symptoms worsened or did not improve after 48 hours. Pain medicines like as ibuprofen, acetaminophen or antipyrine/benzocaine pendants were given in the office at no costliness A follow-up telephone call determined whether the prescription had been filled.

A total of 194 patients were listed and 90 percent of them complet the follow-up interview. Of the 175 families, 120 (69 percent) did not fill the prescription, and 117 said they were willing to use pain medications without antibiotics in the what is yet to be Of the 55 families who did fill the prescription, 33 filled the prescription within 48 hours of diagnosis. A large proportion of these parents cited continued pain or excitement as the reason. Of the variables considered in trying to distinguish between parents who did and did not fill the prescription, the alone predictive variable was previous episodes of AOM. After a child had brace or more AOM episodes, parents were significantly more likely to fill the prescription than parents of a child with single in kind or no AOM episodes.

greatest in quantity parents believe that antibiotics are necessary to treat AOM, unruffled though research has shown that there is little or no benefit in treating this infection with antibiotics. In this close attention the majority of parents did not fill the SNAP and press outed a willingness to avoid antibiotics if their children had AOM in the that will be There were no adverse consequences associated with watchful waiting. However, common child who received antibiotics after 48 hours unraveled mastoiditis in the opposite ear six weeks after treatment. The authors note that limitations of their thought included lack of minority representation and exclusion of inexorable disease.

CAROLINE WELLBERY, MD

Siegel RM et al. Treatment of otitis media with observation and a safety-net antibiotic prescription. Pediatrics September 2003;112:527-31

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