Therapy for acute otitis media. Preference of parents for oral or parenteral antibiotic

H. Bauchner, W. Adams, E. Barnett and J. Klein
Division of General Pediatrics, Boston (Mass) City Hospital, USA.

OBJECTIVE: To determine if parents prefer single-dose intramuscular (IM) therapy or standard 10-day oral therapy for treatment of acute otitis media (AOM). DESIGN: Parents were asked their preference at the time their child was enrolled in a randomized controlled trial comparing the clinical efficacy of single-dose IM ceftriaxone sodium with 10 days of oral amoxicillin and clavulanate potassium for AOM. Additional information was collected at days 3 to 5 and 14 to 16 after the initiation of the therapy. SETTING: Primarily private practices; 15 sites. PATIENTS: For this study, 648 children aged 3 months to 6 years were randomly assigned to receive IM (n=327) or oral (n=321) therapy. RESULTS: The groups were equivalent in all measured sociodemographic factors. At the time of enrollment, 85% of parents expressed a preference for single-dose IM therapy. At days 3 to 5, no differences were reported in days children were absent from school or day care, parental absence from work, or loss of sleep by children. However, more parents with children in the IM therapy group than in the oral therapy group reported loss of sleep by the parent (35% vs 26%, P=.02, chi(2)). At days 14 to 16, more parents with children in the IM group reported being "very satisfied" with the antibiotic (65%) compared with parents whose children 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 current therapy, in contrast to 21% of parents with children in the oral therapy 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 oral therapy.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Consistency of Diagnostic Criteria for Acute Otitis Media: A Review of the Recent Literature
Chandler et al.
CLIN PEDIATR 2007;46:99-108.
ABSTRACT  

Adherence Issues Related to the Selection of Antistaphylococcal or Antifungal Antibiotic Suspensions for Children
Steele et al.
CLIN PEDIATR 2006;45:245-250.
ABSTRACT  

Patient, Physician, and Nurse Satisfaction with Antibiotics
Steele et al.
CLIN PEDIATR 2002;41:285-299.
ABSTRACT  

Improving Parent Knowledge About Antibiotics: A Video Intervention
Bauchner et al.
Pediatrics 2001;108:845-850.
ABSTRACT | FULL TEXT  

Evidence Assessment of Management of Acute Otitis Media: I. The Role of Antibiotics in Treatment of Uncomplicated Acute Otitis Media
Takata et al.
Pediatrics 2001;108:239-247.
ABSTRACT | FULL TEXT  

Reducing Inappropriate Oral Antibiotic Use: A Prescription for Change
Bauchner and Philipp
Pediatrics 1998;102:142-144.
FULL TEXT  

Ceftriaxone for Acute Otitis Media
Eppes et al.
Pediatrics 1997;100:157-157.
FULL TEXT  

A Double-Blind Taste Comparison of Pediatric Antibiotic Suspensions
Steele et al.
CLIN PEDIATR 1997;36:193-199.
ABSTRACT  

Comparison of Ceftriaxone and Trimethoprim-Sulfamethoxazole for Acute Otitis Media
Barnett et al.
Pediatrics 1997;99:23-28.
ABSTRACT | FULL TEXT  

PARENTS PREFER A SINGLE SHOT FOR OTITIS MEDIA
JWatch General 1996;1996:7-7.
FULL TEXT