Waiting to Treat Otitis Media Cuts Down on Antibiotic Use

Substantial reduction in antibiotics as patients try painkillers first

TUESDAY, Sept. 12 (HealthDay News) -- It is possible to substantially reduce antibiotic use among pediatric patients with acute otitis media by adopting a wait-and-see prescription (WASP) approach, according to a study published in the Sept. 13 issue of the Journal of the American Medical Association.

David M. Spiro M.D., M.P.H., formerly of Yale University School of Medicine, New Haven, Conn., and colleagues randomized 283 patients aged six months to 12 years with acute otitis media into two groups: One received a standard prescription of antibiotics (145 patients), and the other received a WASP for antibiotics (138 patients). Ibuprofen and otic analgesic drops were prescribed to both groups.

Among the WASP group, 62 percent did not fill the prescription for antibiotics, compared with 13 percent in the standard prescription group. However, the two groups experienced similar outcomes in terms of fever, otalgia and unscheduled visits for medical treatment.

"The WASP approach may interrupt the cycle of antibiotic prescription, the expectation of parents to immediately treat acute otitis media with an antibiotic, and subsequent medical visits for this illness," the authors concluded.

In an accompanying editorial Paul Little, M.B.B.S., M.D., F.R.C.G.P., of the University of Southampton, Southampton, U.K., writes that delayed prescribing should be acceptable as long as parents are "given clear information about the timing of antibiotic use and specific guidelines for signs and symptoms that should trigger reassessment."

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