THERAPY FOR ACUTE OTITIS-MEDIA - PREFERENCE OF PARENTS FOR ORAL OR PARENTERAL ANTIBIOTIC

Objective: To determine if parents prefer single-dose intramuscular (I M) therapy or standard 10-day oral therapy for treatment of acute otit is media (AOM). Design: Parents were asked their preference at the tim e their child was enrolled in a randomized controlled trial comparing the clinical efficacy of single-dose IM ceftriaxone sodium with 10 day s of oral amoxicillin and clavulanate potassium for AOM. Additional in formation was collected at days 3 to 5 and 14 to 16 after the initiati on of the therapy. Setting: Primarily private practices; 15 sites. Pat ients: For this study, 648 children aged 3 months to 6 years were rand omly assigned to receive IM (n=327) or oral(n=321) therapy. Results: T he groups were equivalent in all measured sociodemographic factors. At the time of enrollment, 85% of parents expressed a preference for sin gle-dose IM therapy. At days 3 to 5, no differences were reported in d ays children were absent from school or day care, parental absence fro m work, or loss of sleep by children. However, more parents with child ren in the IM therapy group than in the oral therapy group reported lo ss of sleep by the parent (35% vs 26%, P=.02, chi(2)). At days 14 to 1 6, more parents with children in the IM group reported being ''very sa tisfied'' with the antibiotic (65%) compared with parents whose childr en were assigned to the oral therapy group (38%, P<.001). In comparing current therapy to past oral therapy for AOM, 71% of the parents with children in the IM therapy group reported more satisfaction with curr ent therapy, in contrast to 21% of parents with children in the oral t herapy group (P<.001). Of the parents, 83% indicated they would prefer single-dose IM therapy for AOM in the future. Conclusion: All of the parents prefer single-dose IM therapy for AOM over standard 10-day ora l therapy.