Decision aid: antibiotics for acute otitis media Acute otitis media (AOM) is really common, with evidence suggesting 90% of children will have at least one episode by the age of 6years. We know that AOM can be caused by viral pathogens, bacteria or a combination of both. There is increasing evidence that antibiotics do not alter the clinical course for most children with mild AOM, with 60% of children experiencing resolution of pain after 24hrs without antibiotic therapy. As a result of this, antibiotic therapy is no longer routinely recommended for mild, uncomplicated cases. The current recommendations for antibiotic therapy (taken from the Queensland Paediatric Emergency guideline) are:
Issuing a 'delayed script' can be useful in these children. Here, we issue a script for antibiotic therapy at the time of presentation and advise parents to commence if symptoms persist for >48hrs. The evidence suggests that this is associated with equivalent parental satisfaction rates (compared to early antibiotic therapy) but can reduce antibiotic usage by up to 2/3. It can be difficult to explain to families why we are not prescribing antibiotics. This decision aid from the Australian Commission on Safety and Quality in Healthcare is a great tool that demonstrates the evidence in graphic form. This can be printed and used as part of a shared decision-making discussion with families. Dr Danielle Scarfe
Comments
|
AuthorsDr Danielle Scarfe Archives
October 2021
Categories
All
|
We Would Love to Have You JOIN US!SPONSORED BY
|
SUPPORT |
PEM CREW |
|