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Antibiotic Dereplication Using the Antibiotic Resistance Platform
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Race, otitis media, and antibiotic selection.

Katherine E Fleming-Dutra1, Daniel J Shapiro2, Lauri A Hicks3

  • 1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; keflemi@emory.edu.

Pediatrics
|November 19, 2014
PubMed
Summary

Racial disparities exist in pediatric otitis media (OM) care. Black children are less likely to receive broad-spectrum antibiotics for OM, suggesting potential race-based differences in physician practices.

Keywords:
NAMCSNHAMCSantibiotic usechildrenotitis mediapediatric

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Area of Science:

  • Pediatric Healthcare
  • Health Disparities
  • Infectious Disease Management

Background:

  • Previous research indicates potential racial bias in otitis media (OM) diagnosis and antibiotic prescribing for children.
  • Concerns exist regarding disparities in care for Black versus non-Black children.

Purpose of the Study:

  • To investigate national-level associations between race and OM diagnosis rates.
  • To determine if race influences antibiotic prescribing patterns for pediatric OM.

Main Methods:

  • Analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (2008-2010).
  • Comparison of OM visit rates and antibiotic prescribing between Black and non-Black children (≤14 years old).
  • Multivariable logistic regression to assess independent association of race with antibiotic selection.

Main Results:

  • OM diagnosis was 30% less frequent during visits for Black children compared to others.
  • No significant difference in OM visit rates per 1000 population between racial groups.
  • Black children were less likely to receive broad-spectrum antibiotics for OM (42% vs. 52%).
  • Black race was independently associated with lower odds of receiving broad-spectrum antibiotics (aOR 0.59).

Conclusions:

  • Findings suggest potential race-based differences in physician practice patterns for pediatric OM.
  • Parental preferences may also contribute to observed disparities in treatment choices.
  • Further research is needed to address racial inequities in otitis media management.