Journal article

Acute otitis media in children: to treat or not to treat?

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Author list: Axelsson, Inge

Publication year: 2000

Start page: 1022

End page: 1032

Number of pages: 11

ISSN: 1392-5261


Abstract

Every day millions of children world-wide take antibiotics against acute otitis media despite the fact that this treatment has not been shown to benefit the otherwise healthy, average AOM patient. Treatment differs greatly between similar, developed countries. These differences do not seem to be based on rational causes but on differences in mentality and culture. An adoptions of Dutch guidelines for AOM in the USA should result in 400.000 fewer US children on antibiotics during one average day! The incidence of severe complications (mastoiditis, meningitis) must be carefully monitored but there is no evidence that these complications are more common in the Netherlands than in the USA. The number of patients who die due to bacteria made antibiotic-resistant by overuse of antibiotics when treating AOM in children is unknown, but is most probably significant (this is never included in ""good versus harm"" calculations). We know little about what treatment is best for children suffering from AOM in poor countries, but it is probably wise to be more aggressive there and to adapt a freer usage of antibiotics than is advisable in rich countries.


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