Doctors Still Give Antibiotics For Ear Infections

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A study presented at the December 2011 clinical meeting of the American Society of Health-System Pharmacists finds that doctors are still prescribing antibiotics for ear infections despite guidelines to the contrary.
The 2004 guidelines set forth by the American Academy of Pediatrics and the American Academy of Family Physicians on the management of acute otitis media have not appreciably altered doctors’ antibiotic prescribing habits.
Margaret L. Hitzeman, who is a PharmD candidate, and Donald G. Klepser, PhD, both from the University of Nebraska in Omaha say that before the guidelines were issued in 2004, 87% of physician visits for acute otitis media resulted in an antibiotic prescription being written.
The percentage dropped to 84% between 2004 and 2006, but fell back to 88% in 2007 and 2008.
“The guidelines recommended a watch-and-wait approach for 72 hours before offering antibiotic treatment, but go ahead and treat for pain with agents such as ibuprofen or acetaminophen. If the patient remains febrile, then begin high-dose amoxicillin,” Hitzeman explained.
“Since the guidelines came out, a number of opinion papers have pointed out that physicians are uncomfortable not prescribing antibiotics for acute otitis media, and there is also considerable patient demand,” she said.
“It will be interesting to see when the next set of guidelines is published if they stick with the initial watch-and-wait approach [because] physicians don’t seem to be willing to follow the recommendation,” she added.