Antibiotics are often unnecessary for acute otitis media, according to an article in the Journal of the American Medical Association.

Overall, 283 children with AOM aged 6 months to 12 years seen in a hospital emergency department were randomly assigned to receive a “wait-and-see prescription” (WASP) or a “standard prescription” (SP). The WASP involved counseling parents to wait 48 hours to fill the prescription, and not to do so if the child’s symptoms improved during that time.

The researchers found that the WASP significantly reduced the use of antibiotics. Substantially more parents in the WASP group did not fill the antibiotic prescription, compared to the SP group (62% vs. 13%). There was no statistically significant difference between the groups in the frequency of subsequent fever, otalgia, or unscheduled medical care. No serious adverse events were reported for patients in the study.

“The routine use of WASP for AOM will reduce both the costs and adverse effects associated with antibiotic treatment and should reduce selective pressure for organisms resistant to commonly used antimicrobials,” the authors conclude.

JAMA – September 13, 2006;296:1235-41.

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