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Antibiotic Use for Acute Otitis Media Assessed

Guideline in 2004 not associated with more management of condition without antibiotics

TUESDAY, Jan. 26 (HealthDay News) -- A well-publicized clinical practice guideline in 2004 on acute otitis media (AOM) in children did not appear to increase the management of the problem without antibiotics, according to research published online Jan. 25 in Pediatrics.

Andrew Coco, M.D., of the Lancaster General Research Institute in Pennsylvania, and colleagues analyzed data from the National Ambulatory Medical Care Survey from 2002 to 2006. The analysis included 1,114 records on cases of AOM in children aged 6 months to 12 years.

The researchers found that the proportion of AOM diagnoses managed without antibiotics didn't change significantly from before to after the guideline (11 to 16 percent). Prescriptions for amoxicillin increased, as did prescriptions for cefdinir, but the use of amoxicillin/clavulanate decreased. The rate of analgesic prescription rose from 14 to 24 percent. Predictors of patient visits in which antibiotics weren't prescribed include absence of ear pain (odds ratio, 3.08), absence of fever (2.70), and prescription for analgesic (2.40).

"Our data suggest that children with AOM who are not prescribed antibiotics are more likely to have mild infections, consistent with the guideline's recommendations. It is encouraging that after the publication of the guideline, amoxicillin-prescribing has increased and the pain associated with AOM is more frequently being treated," the authors write.

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