title: Parental views on acute otitis media (AOM) and its therapy in children--results of an exploratory survey in German childcare facilities.
abstract: BACKGROUND
  Acute otitis media (AOM) is one of the main reasons for medical consultation and antibiotic use during childhood. Although 80% of AOM cases are self-limiting, antibiotic prescription is still high, either for physician- or for parent-related factors. This study aims to identify parental knowledge about, beliefs and attitudes towards, and experiences with AOM and its therapy and thus to gain insights into parents' perspectives within the German health care system.
  
  
  METHODS
  An exploratory survey was conducted among German-speaking parents of children aged 2 to 7 years who sent their children to a childcare facility. Childcare facilities were recruited by convenience sampling in different urban and rural sites in Germany, and all parents with children at those facilities were invited to participate. Data were evaluated using descriptive statistical analyses.
  
  
  RESULTS
  One-hundred-thirty-eight parents participated. Of those, 75.4% (n = 104) were AOM-experienced and 75.4% (n = 104) had two or more children. Sixty-six percent generally agree that bacteria cause AOM. 20.2% generally agree that viruses cause AOM. 30.5% do not generally agree that viruses cause AOM. Eight percent generally agree that AOM resolves spontaneously, whereas 53.6% do not generally agree. 92.5% generally (45.7%) and partly (42.8%) agree that AOM needs antibiotic treatment. With respect to antibiotic effects, 56.6% generally agree that antibiotics rapidly relieve earache. 60.1% generally agree that antibiotics affect the gastrointestinal tract and 77.5% generally agree that antibiotics possibly become ineffective after frequent use. About 40% generally support and about 40% generally reject a "wait-and-see" strategy for AOM treatment. Parental-reported experiences reveal that antibiotics are by far more often prescribed (70.2%) than actively requested by parents (26.9%).
  
  
  CONCLUSIONS
  Parental views on AOM, its therapy, and antibiotic effects reveal uncertainties especially with respect to causes, the natural course of the disease and antibiotic effects on AOM. These results indicate that more evidence-based information is needed if parents' health literacy in the treatment of children with AOM is to be enhanced. The discrepancy between reported parental requests for antibiotics and reported actual prescriptions contradicts the hypothesis of high parental influence on antibiotic use in AOM.
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany. sibylle.kautz-freimuth@uk-koeln.de.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Kautz-Freimuth
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany. marcus.redaelli@uk-koeln.de.|Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. marcus.redaelli@uk-koeln.de.
authors.forename: Marcus
authors.initials: M
authors.lastname: Redaèlli
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany. christina.samel@uk-koeln.de.
authors.forename: Christina
authors.initials: C
authors.lastname: Samel
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany. daniele.civello@uk-koeln.de.
authors.forename: Daniele
authors.initials: D
authors.lastname: Civello
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany. sibel.altin@uk-koeln.de.
authors.forename: Sibel V
authors.initials: SV
authors.lastname: Altin
authors.affiliation: Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany. stephanie.stock@uk-koeln.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stock
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001290:Attitude; D002648:Child; D002656:Child Day Care Centers / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D010287:Parent-Child Relations; D010290:Parents / Q000193:education*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents