Letter

Acute otitis media in children

BMJ 1998; 316 doi: 10.1136/bmj.316.7131.630a (Published 14 February 1998)
Cite this as: BMJ 1998;316:630.2

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Reappraisal of management of acute otitis media is required

  1. Tom Fahey, Senior lecturer,
  2. Deborah Sharp, Professor
  1. Division of Primary Health Care, University of Bristol, Bristol BS8 2PR
  2. Division of General Practice and Primary Care, St George's Hospital Medical School, London SW17 0RE

    EDITOR—Majeed and Harris's editorial on the treatment of acute otitis media in children contains an intellectual non sequitur.1 While acknowledging that over three fifths of children are pain free at 24 hours and that serious complications are rare, they fail to appreciate the trade off between risk and benefit by endorsing the current practice of antibiotic prescribing.

    To a concerned parent whose child has acute otitis media, information can be conveyed in these terms: over half of children with earache are pain free after 24 hours provided symptomatic treatment is given; and for every child who experiences diminished pain between two to seven days, three other children will have vomiting, diarrhoea, or a rash without deriving …

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