The variability and appropriateness of the antibiotic prescription of acute otitis media in childhood

Objective: To know the variability of treatment of acute otitis media in Sp ain and the appropriateness of such with respect to consensus. Material and methods: A descriptive, multicentre, prospective study was carried out in the services of 11 Spanish hospitals. Children diagnosed with acute otitis media and treated on 30 days selected randomly between January and June 199 7 were included. An analysis of treatment variability was made. The results were compared with consensus conference of a panel of experts. Results: Ou t of the 29 436 emergencies studied on 30 days, 821 were diagnosed with acu te otitis media. Fifteen point seven percent of the cases were already rece iving antibiotics (22% amoxicillin clavulanate, 20% amoxicillin and 11% cef uroxime axetil). For the treatment, at discharge, of the 93% an antibiotic was prescribed (amoxicillin clavulanate in 41%, amoxicillin in 15%, cefurox ime axetil in 11%, cefaclor 6% and azithromycin 5%). Two point eight percen t of the children were admitted. According to the guidelines of the panel o f experts consulted, appropriateness was 61% for antibiotics of first choic e, 12% for drugs of alternate use and 25% for inadequate treatment. The dif ferent hospitals presented significant variability in the type of antibioti c used and the appropriateness of such. Conclusions: Acute otitis media is treated with antibiotics in 93% of the cases diagnosed in Spanish hospitals . The most commonly used antibiotics are amoxicillin clavulanate and amoxic illin alone. The prescription and its appropriateness present significant v ariability in the different hospitals studied. (C) 2000 Elsevier Science Ir eland Ltd. All rights reserved.