Watchful Waiting for Children With Acute Otitis Media: Frequency of Use and Outcomes in Clinical Practice
Timothy C Jenkins1,2, Adam L Hersh3, Amy B Stein4
1Division of Infectious Diseases, Department of Medicine, Denver Health and Hospital Authority, Denver, CO, United States.
Insights
Watchful waiting for acute otitis media (AOM) in children is as effective as immediate antibiotics, with similar low failure and adverse event rates. Increasing watchful waiting can reduce unnecessary antibiotic use in pediatric AOM.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Acute otitis media (AOM) is a common pediatric infection.
- Antibiotic overuse for AOM contributes to antimicrobial resistance.
- Current guidelines recommend watchful waiting for some AOM cases.
Purpose of the Study:
- To compare the effectiveness and safety of watchful waiting versus immediate antibiotics for pediatric AOM.
- To assess the impact of watchful waiting on treatment failure and adverse events.
- To evaluate the potential for scaling up watchful waiting to reduce antibiotic exposure.
Main Methods:
- Retrospective analysis of 140,579 pediatric AOM visits.
- Comparison of outcomes between watchful waiting and immediate antibiotic groups.
- Assessment of treatment failure and adverse event rates.
Main Results:
- Watchful waiting was employed in 15.6% of pediatric AOM cases.
- Rates of treatment failure were similar between watchful waiting and immediate antibiotic groups.
- Adverse event rates were also comparable between the two management strategies.
Conclusions:
- Watchful waiting is a safe and effective alternative to immediate antibiotics for pediatric AOM.
- Scaling up watchful waiting can significantly decrease unnecessary antibiotic exposure.
- This approach supports antimicrobial stewardship in pediatric infectious diseases.
Abstract:
Among 140 579 pediatric acute otitis media (AOM) visits, watchful waiting was used in 15.6% of cases and was associated with similarly low rates of treatment failure and adverse events as immediate antibiotics. Scale up of watchful waiting may be an important approach to reduce unnecessary antibiotic exposure for AOM.
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