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Preference of Parents for Oral or Parenteral Antibiotic

Howard Bauchner, MD; William Adams, MD; Elizabeth Barnett, MD; Jerome Klein, MD

Arch Pediatr Adolesc Med. 1996;150(4):396-399.

Abstract
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, 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 singledose 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.

(Arch Pediatr Adolesc Med. 1996;150:396-399)

Author Affiliations
From the Divisions of General Pediatrics (Drs Bauchner and Adams) and Pediatric Infectious Diseases (Drs Barnett and Klein), Boston (Mass) City Hospital, Boston University School of Medicine.

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