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. 2020 Aug 27;21(1):177.
doi: 10.1186/s12875-020-01248-0.

Prescription of antibiotics to children with acute otitis media in Danish general practice

Jonas K Olsen  1 , Jesper Lykkegaard  2   3 , Malene Plejdrup Hansen  3   4 , Frans B Waldorff  2 , Jørgen Lous  2 , Merethe K Andersen  2   3
Affiliations

Prescription of antibiotics to children with acute otitis media in Danish general practice

Jonas K Olsen et al. BMC Fam Pract. .

Abstract

Background: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study's objective was to analyse associations between patient- and general practitioner (GP) characteristics and antibiotic prescribing for children with AOM in an effort to explain the high antibiotic prescribing rates.

Methods: All general practices in the Northern, Southern and Central regions of Denmark were invited to record symptoms, examinations, findings and antibiotic treatment for all children ≤7 years of age diagnosed with AOM during a four-week winter period in 2017/2018. Associations were analysed by means of multivariate logistic regressions. The study design was cross-sectional.

Results: GPs from 60 general practices diagnosed 278 children with AOM of whom 207 (74%) were prescribed antibiotics, most often penicillin V (60%). About half of the children had tympanometry performed. Antibiotic prescribing rates varied considerably between practices (0-100%). Antibiotic prescribing was associated with fever (odds ratio (OR) 3.69 95% confidence interval (CI) 1.93-7.05), purulent ear secretion (OR 2.35 95% CI 1.01-5.50) and poor general condition (OR 3.12 95% CI 1.31-7.46), and the practice's antibiotic prescribing rate to other patients with symptoms of an acute respiratory tract infection (OR 2.85 CI 95% 1.07-7.60) and specifically to other children with AOM (OR 4.15 CI 95% 1.82-9.47).

Conclusion: GPs' antibiotic prescribing rates for children with AOM vary considerably even considering the of signs, symptoms, request for antibiotics, and use of tympanometry. Interventions to reduce overprescribing should be targeted high-prescribing practices.

Keywords: Antibacterial agents; Child; General practice; Guideline adherence; Otitis media.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Proportion of children with AOM treated with antibiotics. - each column represents a GP practice
Fig. 2
Fig. 2
Proportion of all patients treated with antibiotics. - each column represents a GP practice
See this image and copyright information in PMC

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