Amoxicillin for otitis media in general practice

doi:10.1136/bmj.321.7263.765

BMJ 2000;321:765 ( 23 September )

Letters

Amoxicillin for otitis media in general practice

Parental expectations must be dealt with

Time to stop misuse of antibiotics

A grandparent's view

Results do not justify conclusions

Study raises concerns

Authors' reply

Parental expectations must be dealt with

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

EDITOR $---$ The study by Damoiseaux et al adds greatly to the evidence that antibiotics are of limited use in children of all ageswith uncomplicated otitis media.¹ In consultations in generalpractice, however, the decision to prescribe is greatly influencedby considerations arising from the doctor-patient relationship.²Often doctors find it difficult to convince worried parents thatwatchful waiting is acceptable treatment for theirchild.

Many parents see watchful waiting as no treatment and are disappointed by the outcome of the consultation. Sleepless nights,the effort spent in attending the surgery, previous experience,and views of relatives may all increase the expectation of treatment.The challenge in general practice is to present the evidence insuch a way that parents feel empowered at the end of the consultationand more able to cope with the problems their children experience,rather than disempowered when their expectations are not met.General . . . [Full text of this article]

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