Preferred antibiotics for treatment of acute otitis media: comparison of practicing pediatricians, general practitioners, and otolaryngologists.
The antibiotic preferences of 2,190 pediatricians (peds) 360 general practitioners (GPs), and 273 otolaryngologists (ENTs) in the United States and concurrence with treatment guideline recommendations for acute otitis media (AOM) for suspected drug-resistant Streptococcus pneumoniae (DRSP) and beta-lactamase-producing Haemophilus influenzae before and after an educational workshop were compared. Peds and GPs preferred amoxicillin/clavulanate high-dose, whereas ENTs preferred higher generation cephalosporins. Before the workshop, endorsement of guideline-recommended antibiotics for treatment of AOM caused by DRSP by Peds, GPs, and ENTs was 80%, 75%, and 78%, respectively, and for Haemophilus influenzae was 73%, 63%, and 84%, respectively. After the workshop concurrence with AOM guideline recommendations for DRSP increased to 96%, 95%, and 97% and for H. influenzae increased to 93%, 94%, and 96% for Peds, GPs, and ENTs, respectively (p<0.0001 for all comparisons). Peds, GPs, and ENTs select appropriate antibiotics for AOM 63-84% of the time. After instruction that provides the rationale for guideline-recommended agents based on pharmacokinetics/pharmacodynamics and double tympanocentesis trials, endorsement of recommended antibiotics significantly improved to >90%.
Pichichero
Michael E
ME
Elmwood Pediatric Group, University of Rochester Medical Center, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA.
D024881:Drug Resistance, Bacterial; D004502:Education, Medical, Continuing; D019983:Guideline Adherence; D006192:Haemophilus Infections / Q000188:drug therapy*; D006193:Haemophilus influenzae / Q000201:enzymology; D006801:Humans; D010033:Otitis Media / Q000188:drug therapy* / Q000382:microbiology; D010036:Otolaryngology; D010372:Pediatrics; D010821:Physicians, Family; D011008:Pneumococcal Infections / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D013296:Streptococcus pneumoniae; D001618:beta-Lactamases / Q000378:metabolism
D001618:beta-Lactamases