The following is a summary of “Outpatient Antibiotic Prescribing for 357,390 Children With Otitis Media” published in the December 2022 issue of Pediatric Infection by Csonka et al.

The purpose of this research was to examine the antibiotic use for otitis media (OM) in children treated at a vast network of private clinics across the United States from 2014 to 2020. The first-line antibiotics recommended by national guidelines, amoxicillin, and amoxicillin-clavulanic acid, were the subject of this investigation. Macrolides were another area of interest, as they are frequently used to treat children’s respiratory tract infections but are inappropriate for OM. About 250,000 annual visits in children aged 18 were analyzed from their corresponding electronic health records. 

Antibiotic prescriptions, ages of patients, types of doctors seen, and illnesses were all taken into account. Children with OM and upper respiratory tract infections were included. However, those with lower respiratory tract(LRT) infections were not. There were 357,390 children diagnosed with OM, with 55.2% being boys. Prescriptions for antibiotics were given out in 44.8% of all cases, with the lowest rate (44%) found in children younger than 2 years old. There will be a further drop to 41.4% by 2020 from 2014’s 48.3% overall prescription rate. 

Rates for amoxicillin was 19.3%, while those for amoxicillin-clavulanic acid were 18.1% and 12.6%, respectively. The use of macrolides among prescribed medications dropped from 7.5% to 3.5%. Antibiotics were prescribed for 38.8% of children with OM by pediatricians, 54.0% by family doctors, and 39.8% by otolaryngologists. When prescribing antibiotics for OM, 80.1% of pediatricians, 67.0% of family doctors, and 55.1% of ENTs stuck with the guidelines and chose amoxicillin or amoxicillin-clavulanic acid.