Acute otitis media--a brief explanation to parents and antibiotic use.
BACKGROUND
Acute otitis media (AOM) is a common self-limiting disease in children. Antibiotic use is controversial. Physicians in the USA and in Israel prescribe antibiotics almost universally, while physicians in other countries report good outcome without any treatment. Parents' expectation is an important factor influencing a physician's decision to prescribe antibiotics.


OBJECTIVE
Our aim was to assess whether a brief explanation to parents regarding the self-limited nature of AOM and the controversy regarding antibiotic prescription for the disease will influence the parents' decision regarding antibiotics use.


METHODS
Parents of the children participating in the study in two primary care clinics belonging to HMO-Clalit Health Services (CHS) in the southern district of Israel were randomly assigned to an intervention (44) and control (37) group. The intervention group received the brief explanation. The two groups received prescription for antibiotics. The subjects comprised 81 children aged 3 months to 4 years visiting the family practice clinics and diagnosed with AOM. The rate of antibiotics purchase, using the prescription given and the factors influencing the decision were evaluated.


RESULTS
Fewer parents administered antibiotics to their children in the intervention group compared with the control group (37% versus 63%, respectively, P < 0.0001). Mother's education level was the only factor found to be significantly lower in the group that eventually purchased antibiotics (P < 0.05).


CONCLUSIONS
In children with AOM, a brief explanation by the family physician to the child's parents about the disease and the expected spontaneous recovery could decrease antibiotic use by approximately 50%.
Pshetizky
Yaacov
Y
Family Medicine Department, Sial Research Center for Family Medicine and Primary Care, Division of Community Health, Ben-Gurion University of the Negev, Clalit Health Services, 84105 Beer-Sheva, Israel. family@bgumail.bgu.ac.il
Naimer
Sody
S
Shvartzman
Pesach
P
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D006266:Health Education; D006279:Health Maintenance Organizations; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007557:Israel; D008297:Male; D010033:Otitis Media / Q000188:drug therapy*; D010290:Parents / Q000193:education*
D000900:Anti-Bacterial Agents