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Has UK guidance affected general practitioner antibiotic prescribing for otitis media in children?

P L Thompson1, R E Gilbert, P F Long

  • 1Centre for Paediatric Pharmacy Research, The School of Pharmacy, University of London, BMA House, Tavistock Square, London, UK.

Journal of Public Health (Oxford, England)
|September 4, 2008
PubMed

Insights

Antibiotic prescribing for otitis media decreased before UK guidance, with a shift from non-acute to acute diagnoses. This suggests diagnostic changes, not guidance, influenced prescribing trends.

Area of Science:

  • Pediatrics
  • General Practice
  • Pharmacology

Background:

  • UK guidance since 1997 recommended limiting antibiotic prescribing for otitis media.
  • The impact of this guidance on general practitioner prescribing practices was unknown.

Purpose of the Study:

  • To investigate trends in otitis media diagnoses and antibiotic prescribing in children.
  • To analyze these trends in relation to UK guidance.

Main Methods:

  • Time-trend analyses of diagnoses and antibiotic prescribing for otitis media.
  • Utilized the General Practice Research Database for children aged 3 months to 15 years (1990-2006).

Main Results:

  • Over 1.2 million otitis media episodes were analyzed; 68% received antibiotics.
  • Antibiotic prescribing for otitis media declined by 51% between 1995-2000, predating guidance.
  • Prescribing for acute otitis media increased by 22% during this period, with diagnoses paralleling prescribing.

Conclusions:

  • The observed reduction in antibiotic prescribing for otitis media preceded official guidance.
  • A shift in coding from non-acute to acute otitis media suggests diagnostic transfer may have influenced prescribing decisions.
Abstract

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