Reaction toward a new treatment paradigm for acute otitis media

Objective: Recent evidence suggests that oral antibiotics may not be required in all children with acute otitis media (AOM). We determined whether parents and pediatricians were aware of and comfortable with a policy of selective use of antibiotics for AOM. Methods: Design - Descriptive survey. Settings - Suburban academic emergency department, urgent care center, and private pediatric practices. Participants - Parents of children presenting to an emergency department and urgent care center and pediatricians in faculty and private practice. Interventions and Outcomes - Parents were asked whether they were aware of any side effects associated with antibiotic use or of research that supports selective use of antibiotics for AOM. Physicians were queried regarding the methods used to diagnose AOM and their patterns of prescribing antibiotics for AOM. Parents and physicians were questioned regarding their comfort with withholding antibiotics for AOM using a 6-point Likert scale ranging from very uncomfortable to very comfortable. Results: Six hundred fifty-four parents and 84 physicians were surveyed. Sixty-one percent of parents were unaware of the potential side effects of antibiotics, and 72% were unaware of research supporting selective use of antibiotics. Fifty-three percent of parents and 73% of physicians were somewhat comfortable to very comfortable with an observation option for AOM. Half of all pediatricians stated that they always prescribe antibiotic for AOM. Conclusions: Although most parents are unaware of selective use of antibiotics and half of all surveyed pediatricians stated that they always prescribed antibiotics for AOM, many parents and pediatricians felt comfortable with selective use of antibiotics.