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Therapy for acute otitis media. Preference of parents for oral or parenteral antibiotic
H Bauchner1, W Adams, E Barnett
1Division of General Pediatrics, Boston (Mass) City Hospital, USA.
Insights
Parents overwhelmingly prefer single-dose intramuscular (IM) antibiotic therapy over standard 10-day oral medication for acute otitis media (AOM). This preference stems from higher satisfaction with IM treatment, despite minor parental sleep disruption.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
- Clinical trial research
Background:
- Acute otitis media (AOM) is a common childhood infection.
- Standard treatment involves 10-day oral antibiotic courses.
- Alternative single-dose intramuscular (IM) therapies are being explored.
Purpose of the Study:
- To compare parental preference between single-dose IM and 10-day oral antibiotic therapy for AOM.
- To assess parental satisfaction with different AOM treatment regimens.
Main Methods:
- A randomized controlled trial compared IM ceftriaxone sodium with oral amoxicillin and clavulanate potassium for AOM.
- Parental preferences and satisfaction were surveyed at enrollment and follow-up (days 3-5 and 14-16).
- 648 children aged 3 months to 6 years were enrolled across 15 private practice sites.
Main Results:
- 85% of parents initially preferred single-dose IM therapy.
- At follow-up, 65% of parents in the IM group reported high satisfaction versus 38% in the oral group (P<.001).
- 83% of parents indicated a future preference for single-dose IM therapy for AOM.
Conclusions:
- Single-dose IM therapy is strongly preferred by parents over standard 10-day oral therapy for AOM.
- Parental satisfaction is significantly higher with single-dose IM treatment.
- IM therapy offers a potentially more convenient and satisfactory treatment option for AOM.
Objective:
To determine if parents prefer single-dose intramuscular (IM) therapy or standard 10-day oral therapy for treatment of acute otitis media (AOM).
Design:
Parents were asked their preference at the time their child was enrolled in a randomized controlled trial comparing the clinical efficacy of single-dose IM ceftriaxone sodium with 10 days of oral amoxicillin and clavulanate potassium for AOM. Additional information was collected at days 3 to 5 and 14 to 16 after the initiation of the therapy.
Setting:
Primarily private practices; 15 sites.
Patients:
For this study, 648 children aged 3 months to 6 years were randomly assigned to receive IM (n=327) or oral (n=321) therapy.
Results:
The groups were equivalent in all measured sociodemographic factors. At the time of enrollment, 85% of parents expressed a preference for single-dose IM therapy. At days 3 to 5, no differences were reported in days children were absent from school or day care, parental absence from work, or loss of sleep by children. However, more parents with children in the IM therapy group than in the oral therapy group reported loss of sleep by the parent (35% vs 26%, P=.02, chi(2)). At days 14 to 16, more parents with children in the IM group reported being "very satisfied" with the antibiotic (65%) compared with parents whose children were assigned to the oral therapy group (38%, P<.001). In comparing current therapy to past oral therapy for AOM, 71% of the parents with children in the IM therapy group reported more satisfaction with current therapy, in contrast to 21% of parents with children in the oral therapy group (P<.001). Of the parents, 83% indicated they would prefer single-dose IM therapy for AOM in the future.
Conclusion:
All of the parents prefer single-dose IM therapy for AOM over standard 10-day oral therapy.