title: Parental acceptability of the watchful waiting approach in pediatric acute otitis media.
abstract: OBJECTIVE
  To determine parental knowledge about acute otitis media (AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting (WW) approach in primary care settings in southern Israel.
  
  
  METHODS
  The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires (20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents (150 at each centers) of children < 6 years of age.
  
  
  RESULTS
  Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach.
  
  
  CONCLUSIONS
  A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.
authors.affiliation: Arnon Broides, Yariv Fruchtman, Eugene Leibovitz, Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84140, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Broides
authors.affiliation: Arnon Broides, Yariv Fruchtman, Eugene Leibovitz, Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84140, Israel.
authors.forename: Olga
authors.initials: O
authors.lastname: Bereza
authors.affiliation: Arnon Broides, Yariv Fruchtman, Eugene Leibovitz, Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84140, Israel.
authors.forename: Noga
authors.initials: N
authors.lastname: Lavi-Givon
authors.affiliation: Arnon Broides, Yariv Fruchtman, Eugene Leibovitz, Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84140, Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Fruchtman
authors.affiliation: Arnon Broides, Yariv Fruchtman, Eugene Leibovitz, Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84140, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Gazala
authors.affiliation: Arnon Broides, Yariv Fruchtman, Eugene Leibovitz, Pediatric Emergency Department, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84140, Israel.
authors.forename: Eugene
authors.initials: E
authors.lastname: Leibovitz
keywords: Acute otitis media; Antibiotics; Bacteria; Children; Parents; Resistance; Watchful waiting