Acute otitis media in children

BMJ 1998;316:630 ( 21 February )

Letters

Acute otitis media in children

Reappraisal of management of acute otitis media is required

Authors' reply

Reappraisal of management of acute otitis media is required

The first 150 words of the full text of this article appear below.

EDITOR $---$ Majeed and Harris's editorial on the treatment of acute otitis media in children contains an intellectual non sequitur.¹While acknowledging that over three fifths of children are painfree at 24 hours and that serious complications are rare, theyfail to appreciate the trade off between risk and benefit by endorsingthe 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 childrenwith earache are pain free after 24 hours provided symptomatictreatment is given; and for every child who experiences diminishedpain between two to seven days, three other children will havevomiting, diarrhoea, or a rash without deriving any benefit froman antibiotic.² Even this statement ignores other hazards associatedwith antibiotic treatment: the medicalisation of a self limitingcondition,³ the increase in antibiotic resistance over time,⁴and the opportunity costs of . . . [Full text of this article]

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