So should antibiotics be routinely prescribed for AOM?

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So should antibiotics be routinely prescribed for AOM?

Some children treated with antibiotics for AOM may be less likely to have pain 2-7 days after the first symptoms. But it is difficult to predict which child will benefit in this way - one study suggested that 17 must be treated for just one to benefit (See pg 26 of the SMAC report for more details). The small chance of benefit of antibiotics in AOM must be balanced against the risk of side effects, the risk of increasing parents' belief in the important of antibiotics and the contribution to the development of antibiotic resistance by overuse of antibiotics. Another reason for prescribing antibiotics in AOM may be the risk of complications with AOM. However, it has been shown that those countries that don't prescribe antibiotics for AOM as often as some other countries do not have any increase in the risk of complications. Although some think that the chance of benefit for one child is enough reason to treat all (see the Bandolier article). The general conclusion of the SMAC report was that antibiotics are probably unecessary in AOM.

In some cases a doctor will decide that it is appropriate to prescribe antibiotics for AOM, but how long should a course of treatment be? There is debate about the appropriate length of treatment but one study showed that 3 and 10 day courses were equally effective (see pg 26 of the SMAC report) whilst many studies have shown that 5 day courses are as effective as 10 day courses.

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Date of Posting: 21/01/2003
Date of next Review: 15/01/2005

Related Questions:
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MeSH keywords:
Earache; Otitis Media; Antibiotics

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