title: Demographic influences on antibiotic prescribing for pediatric acute otitis media.
abstract: OBJECTIVE
  To understand the epidemiologic antibiotic treatment patterns and the potential impact of race and insurance status on the medical management of acute otitis media (AOM).
  
  
  METHODS
  Cross-sectional analysis of a national database.
  
  
  METHODS
  National ambulatory care setting.
  
  
  METHODS
  Cases of isolated AOM in children ≤ 16.0 years were extracted from the National Ambulatory Medical Care Survey (2006-2008). The frequency and type of antibiotic prescribed were extracted. A multivariate logistic regression model incorporating age, sex, race, ethnicity, and insurance type was used to determine the influence of these demographic variables on antibiotic prescribing patterns.
  
  
  RESULTS
  A total of 15.8 ± 1.5 million cases of AOM were studied (mean age, 3.6 ± 0.3 years; 55.1% ± 2.9% male). Of the children, 15.0% ± 2.8% were Hispanic and 10.4% ± 3.1% were black. Medicaid/State Children's Health Insurance Program and private insurance covered 30.6% ± 4.4% and 69.4% ± 4.4% of children, respectively. Overall, 83.1% ± 2.2% of children received an antibiotic prescription. The most commonly prescribed antibiotics were amoxicillin (6.5 ± 0.9 million), beta-lactamase inhibitors (2.6 ± 0.4 million), and third-generation cephalosporins (2.3 ± 0.4 million prescriptions). On multivariate analysis, insurance status, ethnicity, race, age, and sex did not influence the likelihood of an antibiotic being prescribed during the visit (P = .884, .909, .849, .102, and .931 respectively).
  
  
  CONCLUSIONS
  Most children receiving medical treatment for AOM receive an antibiotic prescription during their visit. Ethnicity, race, and insurance type do not significantly influence antibiotic prescribing rates for AOM, and nearly all patients have medical insurance.
authors.affiliation: Division of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1624, USA. dsidell@mednet.ucla.edu
authors.forename: Douglas
authors.initials: D
authors.lastname: Sidell
authors.forename: Nina L
authors.initials: NL
authors.lastname: Shapiro
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003710:Demography; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010033:Otitis Media / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents