A Common Diagnosis Too Often Leads to Overprescribing of Common Drugs

Parents presenting with children whose symptoms are suspicious for acute otitis media (AOM) are aplenty in urgent care, as well as in other settings. Unfortunately, too many of those parents expect—or even demand—a prescription for an antibiotic before leaving. And, in fact, often they’ll get just that whether it’s truly warranted or not. An article just published in JAMA Pediatrics suggests it’s time to remind ourselves, collectively, that such a kneejerk reaction may not be in the best interests of the patient, or patients to come. That argument is supported by current guidelines from the American Academy of Pediatrics, which recommend observation or a delayed prescription rather than getting a child started on an antibiotic ASAP. The article also points out a disparity in next steps when an antibiotic really is warranted, highlighting the fact that almost 40% of antibiotics prescribed as first-line therapy are broad spectrum, in spite of the fact that amoxicillin is the recommended first-line drug of choice. On a related note, JUCM published an article recently revealing that the COVID-19 pandemic may have inadvertently been beneficial in curbing overuse of antibiotics in AOM, as parents wound up waiting longer to take their kids to urgent care due to a garden-variety earache. You can read Time to Presentation for Acute Otitis Media During the COVID-19 Pandemic in our archive. For a more general approach to AOM in the urgent care setting, read Urgent Care Management of Acute Otitis Media in Children.