Factors associated with antibiotic prescribing in children with otitis media

Christina T Ryborg, Jens Søndergaard, Jørgen Lous, Anders Munck, Pia V Larsen, Malene Plejdrup Hansen, Janus Laust Thomsen

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background. Acute otitis media (AOM) is often treated with antibiotics. However, initial observation is recommended. Denmark has a low use of antibiotics compared with other countries, but the total use of antibiotics has increased by 32% during the last decade, and it is important to know whether general practitioners (GPs) prescribe antibiotics according to guidelines. 

Objective. The aim of the study was to analyse associations between GPs' antibiotic prescribing for AOM and symptoms, diagnoses, and characteristics of children. Methods. A cohort study where GPs consecutively included 954 children between 0 and 7 years old with a new ear symptom was carried out. The GPs registered symptoms, results of otoscopy and tympanometry, together with diagnosis and treatment. 

Results. Fever with and without earache was statistically associated with prescribing antibiotics, and it applies to both children up to two years of age (OR: 5.89 (confidence interval (CI): 2.62-13.21) and OR: 8.13 (CI: 4.61-14.32)) and children older than two years of age (OR: 4.59 (CI: 2.55-8.25) and OR: 19.45 (CI: 6.38-59.24)). A red tympanic membrane was statistically associated with the prescribing antibiotics in both age groups (0-2 years: OR: 4.73 (CI: 2.52-8.86) and >2-7 years: OR: 3.76 (CI: 2.13-6.64)). A flat tympanometry curve was only statistically associated with prescribing antibiotics in the oldest children (OR: 2.42 (CI: 1.17-5.00)). 

Conclusion. This study indicates that GPs to a large degree prescribe antibiotics appropriately according to guidelines.

Original languageEnglish
Pages (from-to)587452
Number of pages7
JournalISRN family medicine
Volume2013
DOIs
Publication statusPublished - 2013
Externally publishedYes

Fingerprint

Otitis Media
Anti-Bacterial Agents
Confidence Intervals
General Practitioners
Acoustic Impedance Tests
Otoscopy
Earache
Guidelines
Tympanic Membrane
Denmark
Ear
Cohort Studies
Fever
Age Groups
Observation

Cite this

Ryborg, C. T., Søndergaard, J., Lous, J., Munck, A., Larsen, P. V., Hansen, M. P., & Thomsen, J. L. (2013). Factors associated with antibiotic prescribing in children with otitis media. ISRN family medicine, 2013, 587452. https://doi.org/10.5402/2013/587452
Ryborg, Christina T ; Søndergaard, Jens ; Lous, Jørgen ; Munck, Anders ; Larsen, Pia V ; Hansen, Malene Plejdrup ; Thomsen, Janus Laust. / Factors associated with antibiotic prescribing in children with otitis media. In: ISRN family medicine. 2013 ; Vol. 2013. pp. 587452.
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title = "Factors associated with antibiotic prescribing in children with otitis media",
abstract = "Background. Acute otitis media (AOM) is often treated with antibiotics. However, initial observation is recommended. Denmark has a low use of antibiotics compared with other countries, but the total use of antibiotics has increased by 32{\%} during the last decade, and it is important to know whether general practitioners (GPs) prescribe antibiotics according to guidelines. Objective. The aim of the study was to analyse associations between GPs' antibiotic prescribing for AOM and symptoms, diagnoses, and characteristics of children. Methods. A cohort study where GPs consecutively included 954 children between 0 and 7 years old with a new ear symptom was carried out. The GPs registered symptoms, results of otoscopy and tympanometry, together with diagnosis and treatment. Results. Fever with and without earache was statistically associated with prescribing antibiotics, and it applies to both children up to two years of age (OR: 5.89 (confidence interval (CI): 2.62-13.21) and OR: 8.13 (CI: 4.61-14.32)) and children older than two years of age (OR: 4.59 (CI: 2.55-8.25) and OR: 19.45 (CI: 6.38-59.24)). A red tympanic membrane was statistically associated with the prescribing antibiotics in both age groups (0-2 years: OR: 4.73 (CI: 2.52-8.86) and >2-7 years: OR: 3.76 (CI: 2.13-6.64)). A flat tympanometry curve was only statistically associated with prescribing antibiotics in the oldest children (OR: 2.42 (CI: 1.17-5.00)). Conclusion. This study indicates that GPs to a large degree prescribe antibiotics appropriately according to guidelines.",
author = "Ryborg, {Christina T} and Jens S{\o}ndergaard and J{\o}rgen Lous and Anders Munck and Larsen, {Pia V} and Hansen, {Malene Plejdrup} and Thomsen, {Janus Laust}",
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Ryborg, CT, Søndergaard, J, Lous, J, Munck, A, Larsen, PV, Hansen, MP & Thomsen, JL 2013, 'Factors associated with antibiotic prescribing in children with otitis media' ISRN family medicine, vol. 2013, pp. 587452. https://doi.org/10.5402/2013/587452

Factors associated with antibiotic prescribing in children with otitis media. / Ryborg, Christina T; Søndergaard, Jens; Lous, Jørgen; Munck, Anders; Larsen, Pia V; Hansen, Malene Plejdrup; Thomsen, Janus Laust.

In: ISRN family medicine, Vol. 2013, 2013, p. 587452.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Factors associated with antibiotic prescribing in children with otitis media

AU - Ryborg, Christina T

AU - Søndergaard, Jens

AU - Lous, Jørgen

AU - Munck, Anders

AU - Larsen, Pia V

AU - Hansen, Malene Plejdrup

AU - Thomsen, Janus Laust

PY - 2013

Y1 - 2013

N2 - Background. Acute otitis media (AOM) is often treated with antibiotics. However, initial observation is recommended. Denmark has a low use of antibiotics compared with other countries, but the total use of antibiotics has increased by 32% during the last decade, and it is important to know whether general practitioners (GPs) prescribe antibiotics according to guidelines. Objective. The aim of the study was to analyse associations between GPs' antibiotic prescribing for AOM and symptoms, diagnoses, and characteristics of children. Methods. A cohort study where GPs consecutively included 954 children between 0 and 7 years old with a new ear symptom was carried out. The GPs registered symptoms, results of otoscopy and tympanometry, together with diagnosis and treatment. Results. Fever with and without earache was statistically associated with prescribing antibiotics, and it applies to both children up to two years of age (OR: 5.89 (confidence interval (CI): 2.62-13.21) and OR: 8.13 (CI: 4.61-14.32)) and children older than two years of age (OR: 4.59 (CI: 2.55-8.25) and OR: 19.45 (CI: 6.38-59.24)). A red tympanic membrane was statistically associated with the prescribing antibiotics in both age groups (0-2 years: OR: 4.73 (CI: 2.52-8.86) and >2-7 years: OR: 3.76 (CI: 2.13-6.64)). A flat tympanometry curve was only statistically associated with prescribing antibiotics in the oldest children (OR: 2.42 (CI: 1.17-5.00)). Conclusion. This study indicates that GPs to a large degree prescribe antibiotics appropriately according to guidelines.

AB - Background. Acute otitis media (AOM) is often treated with antibiotics. However, initial observation is recommended. Denmark has a low use of antibiotics compared with other countries, but the total use of antibiotics has increased by 32% during the last decade, and it is important to know whether general practitioners (GPs) prescribe antibiotics according to guidelines. Objective. The aim of the study was to analyse associations between GPs' antibiotic prescribing for AOM and symptoms, diagnoses, and characteristics of children. Methods. A cohort study where GPs consecutively included 954 children between 0 and 7 years old with a new ear symptom was carried out. The GPs registered symptoms, results of otoscopy and tympanometry, together with diagnosis and treatment. Results. Fever with and without earache was statistically associated with prescribing antibiotics, and it applies to both children up to two years of age (OR: 5.89 (confidence interval (CI): 2.62-13.21) and OR: 8.13 (CI: 4.61-14.32)) and children older than two years of age (OR: 4.59 (CI: 2.55-8.25) and OR: 19.45 (CI: 6.38-59.24)). A red tympanic membrane was statistically associated with the prescribing antibiotics in both age groups (0-2 years: OR: 4.73 (CI: 2.52-8.86) and >2-7 years: OR: 3.76 (CI: 2.13-6.64)). A flat tympanometry curve was only statistically associated with prescribing antibiotics in the oldest children (OR: 2.42 (CI: 1.17-5.00)). Conclusion. This study indicates that GPs to a large degree prescribe antibiotics appropriately according to guidelines.

U2 - 10.5402/2013/587452

DO - 10.5402/2013/587452

M3 - Article

VL - 2013

SP - 587452

JO - ISRN family medicine

JF - ISRN family medicine

SN - 2314-4769

ER -

Ryborg CT, Søndergaard J, Lous J, Munck A, Larsen PV, Hansen MP et al. Factors associated with antibiotic prescribing in children with otitis media. ISRN family medicine. 2013;2013:587452. https://doi.org/10.5402/2013/587452