Decision-making in otitis media in children, Part I: epidemiologic data and definitions for a reliable cost-effectiveness analysis.
There is a gap between the medical and economic weight of acute otitis media and the imprecise knowledge and irrational attitude towards diagnosis and treatment. The wide variations among prescribers need to be analyzed. Precise definitions are proposed for acute otitis media and endpoints for outcomes being estimated. An empirical antibiotic treatment gives a greater cure rate than a conservative approach with antipyretic and analgesic drugs. The incremental efficacy expected from more extended-spectrum antibacterials is not clinically significant.
Grenier
Bernard
B
Professor, Faculty of Medicine, Tours, France.