An evidence based approach to reducing antibiotic use in children with acute otitis media: controlled before and after study

Two recent reviews questioned the routine use of antibiotics in the initial management of acute otitis media. 1 2 My practice partners and I responded to the reviews by changing our policy, with the aim of reducing such prescribing in children. We measured the change one year after adopting the new policy. From July 1997 my practice partners and I changed our policy on routine prescription of antibiotics in the initial management of acute otitis media in children. In children who were not particularly ill we gave the parents a handout that summarised the limited benefit of antibiotics on the basis of the data presented in the Cochrane review.1 We advised parents to give regular paracetamol suspension; we also offered an antibiotic prescription but asked the parents to keep it for a day or two. They could redeem it at a pharmacy if the child did not got better over this period. A local practice acted as a concurrent control. Both practices use …