Thomas Fischer1, Adam J Singer, Stuart Chale. 1. Department of Emergency Medicine, Stony Brook University Medical Center, Stony Brook, NY 11794, USA. tomfxf@optonline.net
Abstract
OBJECTIVES: The objective of our study was to evaluate the efficacy of the observation option for the treatment of acute otitis media (AOM) in the emergency department (ED). METHODS: The study was designed as a prospective case series. It was conducted in a suburban academic emergency department, with pediatric patients 2 years or older as participants. INTERVENTIONS AND OUTCOMES: The patient population consisted of children 2 years or older with conditions diagnosed as AOM. Patients were excluded if they had a history of any potentially immunocompromising conditions or a history of recurrent AOM. Patients were treated with ibuprofen or acetaminophen in the ED. The parents were given a prescription for antibiotics but were asked not to fill the prescription immediately. Parents were contacted by phone for follow-up. RESULTS: One hundred forty-four patients were enrolled in the study. One hundred five (73%) recovered uneventfully without ever requiring antibiotics. Thirty-nine patients were treated with antibiotics. Of the 39 patients who were started on antibiotics, 11 patients had at least 1 episode of vomiting or diarrhea, and 5 of these patients had their antibiotic changed because of it. CONCLUSIONS: Our study demonstrates that the observation option as defined by the New York Otitis Project Committee can be safely implemented in the ED and prevented the administration of antibiotics in more than 70% of the patients in our group. This suggests that if the observation option became the standard of care for the treatment of AOM, antibiotic administration for this disease could be significantly reduced.
OBJECTIVES: The objective of our study was to evaluate the efficacy of the observation option for the treatment of acute otitis media (AOM) in the emergency department (ED). METHODS: The study was designed as a prospective case series. It was conducted in a suburban academic emergency department, with pediatric patients 2 years or older as participants. INTERVENTIONS AND OUTCOMES: The patient population consisted of children 2 years or older with conditions diagnosed as AOM. Patients were excluded if they had a history of any potentially immunocompromising conditions or a history of recurrent AOM. Patients were treated with ibuprofen or acetaminophen in the ED. The parents were given a prescription for antibiotics but were asked not to fill the prescription immediately. Parents were contacted by phone for follow-up. RESULTS: One hundred forty-four patients were enrolled in the study. One hundred five (73%) recovered uneventfully without ever requiring antibiotics. Thirty-nine patients were treated with antibiotics. Of the 39 patients who were started on antibiotics, 11 patients had at least 1 episode of vomiting or diarrhea, and 5 of these patients had their antibiotic changed because of it. CONCLUSIONS: Our study demonstrates that the observation option as defined by the New York Otitis Project Committee can be safely implemented in the ED and prevented the administration of antibiotics in more than 70% of the patients in our group. This suggests that if the observation option became the standard of care for the treatment of AOM, antibiotic administration for this disease could be significantly reduced.
Authors: Beth Stuart; Hilda Hounkpatin; Taeko Becque; Guiqing Yao; Shihua Zhu; Pablo Alonso-Coello; Attila Altiner; Bruce Arroll; Dankmar Böhning; Jennifer Bostock; Heiner C Bucher; Jennifer Chao; Mariam de la Poza; Nick Francis; David Gillespie; Alastair D Hay; Timothy Kenealy; Christin Löffler; David P McCormick; Gemma Mas-Dalmau; Laura Muñoz; Kirsty Samuel; Michael Moore; Paul Little Journal: BMJ Date: 2021-04-28
Authors: Elles M F van de Voort; Santiago Mintegi; Alain Gervaix; Henriette A Moll; Rianne Oostenbrink Journal: Front Pediatr Date: 2018-10-08 Impact factor: 3.418