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Otitis media treatment in New Zealand general practice
M W Tilyard1, S M Dovey, S A Walker
1Department of General Practice, Dunedin School of Medicine.
Aims:
To compare incidence and general practice treatments for acute (AOM), serous (OME), and recurrent (ROM) otitis media in New Zealand.
Methods:
A retrospective analysis of 2901 consultations for otitis media was undertaken. Specific diagnostic groups were compared for antibiotic treatments offered, duration of therapy, and treatment success. Twenty New Zealand general practices contributed 290100 computerised consultation records generated between 1 July 1993 and 30 June 1994. Records from 2089 otitis media patients were examined to determine incidence and treatment success.
Results:
Most initial acute otitis media and recurrent otitis media presentations resulted in antibiotic treatment (96.6% and 94.9%): fewer otitis media with effusion presentations (77.6%) were initially treated with antibiotics. Age and treatment success were significantly associated for patients with acute otitis media: patients < 2 years were least likely to be successfully treated (p < 0.0001). There was no difference in success rates between antibiotic and no antibiotic therapies. Antibiotic therapy duration ranged from < 6 days to 40 days. Shorter courses were as likely as longer courses to be successful for all diagnoses.
Conclusions:
The outcome of otitis media episodes is more closely related to patients' age than to specific diagnosis, type or duration of therapy.