title: The incidence of acute otitis media in New Zealand children under five years of age in the primary care setting.
abstract: BACKGROUND
  Acute otitis media (AOM) is a common childhood infection. Baseline data are required to evaluate potential changes in the epidemiology of AOM with new public health measures.
  
  
  OBJECTIVE
  To estimate the incidence of AOM in children under five years of age in primary care in New Zealand.
  
  
  METHODS
  Using a cohort study design, consultation notes from 1 November 2008 to 31 October 2009 from 63 primary care facilities were analysed for new and recurrent episodes of AOM, complications, antimicrobial use and outcome.
  
  
  RESULTS
  There were 19 146 children in the sample. The raw incidence of AOM was 273 per 1000 children (27.3%; 95% CI 216-330). Of the 3885 children, 2888 (74%) had one episode of AOM and 152 (4%) of these children developed recurrent AOM. Incidence declined with age. There was no difference in incidence between Maori, Pacific and 'Other' ethnicities. Antibiotics were used to treat 2653 (51%) AOM episodes and 113 (4.3%) of these children re-presented within three days of antibiotic therapy for persistent symptoms. Tympanic membrane perforation was the only complication noted, observed in 62 (1%) episodes.
  
  
  CONCLUSIONS
  These data indicate that AOM is an important and frequent childhood infection in New Zealand. The show a significant decline in the use of antibiotics to manage AOM in concordance with accepted best practice. The complication rate of AOM is likely under-represented. This study enables future research into the effectiveness of current and future immunisations and changing management practices in New Zealand.
authors.affiliation: CBG Health Research Limited, Auckland, New Zealand.
authors.forename: Barry
authors.initials: B
authors.lastname: Gribben
authors.forename: Lesley J
authors.initials: LJ
authors.lastname: Salkeld
authors.forename: Simon
authors.initials: S
authors.lastname: Hoare
authors.forename: Hannah F
authors.initials: HF
authors.lastname: Jones
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010033:Otitis Media / Q000188:drug therapy / Q000453:epidemiology*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D000900:Anti-Bacterial Agents