Delaying antibiotic treatment for ear infections is a feasible and acceptable strategy

Pragmatic randomised controlled trial of two prescribing strategies for childhood acute otitis media

A "wait and see" approach, compared to immediate prescription of antibiotics for acute otitis media (ear infection) in children, is feasible, acceptable to parents, and should substantially reduce use of antibiotics, finds a study in this week's BMJ.

Parents of 315 children, aged between 6 months and 10 years, attending general practices with acute otitis media were randomly offered two treatment strategies - immediate antibiotics or delayed antibiotics (parents asked to wait 72 hours after seeing the doctor before considering using the prescription). Immediate antibiotics provided benefits compared with delayed prescribing, such as reduced duration of illness and fewer nights disturbed, but mainly after the first 24 hours, when distress and symptoms were already improving. Immediate antibiotics also increased diarrhoea by 10% and increased parents' belief in their effectiveness.

Overall, 77% of parents given delayed prescriptions were very satisfied with the "wait and see" approach. Furthermore, fewer believed in the effectiveness of antibiotics and in the need to see their doctor with the same problem in future. This approach also resulted in a 76% reduction in the use of antibiotic prescriptions, helping to reduce the danger of antibiotic resistance, conclude the authors.

Contact:

Paul Little, MRC Clinician Scientist, Community Clinical Sciences (Primary Medical Care Group), University of Southampton, Aldermoor Health Centre, Southampton, UK Email: psl3@soton.ac.uk