Related Experiment Video
Updated: Feb 17, 2026
Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia
Published on: May 6, 2014
Treatment of Acute Otitis Media in the Pediatric Emergency Department
Sarah Rothman1, Jacob Pitaro1, Asher Hackett2
1From the Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler School of Medicine, Zerifin, Israel.
Insights
Over-treatment of acute otitis media (AOM) is common. This study found that while most AOM treatments followed guidelines, nearly 21% were inappropriate, often due to incorrect antibiotic type or duration.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Over-treatment of acute otitis media (AOM) with antibiotics is a significant healthcare burden.
- Current guidelines recommend watchful waiting for most mild-to-moderate AOM cases.
Purpose of the Study:
- To evaluate the appropriateness of AOM treatment in a pediatric emergency department.
- To assess adherence to local guidelines regarding antibiotic use and watchful waiting.
Main Methods:
- Retrospective review of AOM cases in children aged 6-36 months (2014-2016).
- Analysis of prescribed treatments (watchful waiting vs. antibiotics), including antibiotic type and duration.
- Evaluation of treatment appropriateness against local guidelines.
Main Results:
- Of 1493 AOM visits, 96.2% received antibiotic therapy upon discharge, with an average duration of 8.29 days.
- Treatment appropriateness was assessed in 1134 visits, with 20.9% deemed inappropriate, primarily due to incorrect antibiotic type and duration.
- Amoxicillin was the most frequently prescribed antibiotic.
Conclusions:
- Adherence to local guidelines for uncomplicated AOM treatment was generally high.
- Despite overall adherence, a notable percentage of treatments were inappropriate, highlighting areas for improvement in antibiotic stewardship.
Background:
Over-treatment of acute otitis media (AOM) with antibiotics is common, and poses a high burden on health-care systems.
Methods:
Records of children 6-36 months of age with AOM visiting a university-affiliated pediatric emergency department between 2014 and 2016 were reviewed for the treatment given: watchful waiting versus antibiotics. If antibiotics were prescribed, the type and duration were recorded. We evaluated appropriate and inappropriate treatment rates of eligible AOM cases, in respect to the local guidelines, which encourage watchful waiting in most mild-moderate cases.
Results:
Out of 1493 AOM visits, 863 (57.8%) were boys, with a median age of 14.9 months (interquartile range, 9-19). The overall pre-visit antibiotic rate was 24.1%, but among those children examined by a physician, this rate was 95.2%. Amoxicillin was the most common antibiotic, administered in 66.3% of the cases. Only 21 children (5.8%) had been treated with antibiotics for ≥7 days before their visit, and were considered as treatment failure. Antibiotic therapy upon discharge was recorded in 1394/1449 visits (96.2%), again with amoxicillin as the most common antibiotic therapy, in 80.8% of the cases. In these visits, the average duration of antibiotic treatment was 8.29 days. Appropriateness of treatment (watchful waiting or antibiotics) could be analyzed in 1134 visits; 20.9% were considered as inappropriate. Of them, 98.3% were prescribed with the wrong antibiotic type and duration.
Conclusions:
Adherence rate to the local guidelines treatment recommendations for uncomplicated AOM was high, as measured by whether appropriate treatment was given and type and duration of antibiotics.
Related Concept Videos
01:26Tonsillitis II: Management
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...