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Initial declines in antibiotic prescriptions for OM may be tapering off
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Changes in vaccination recommendations combined with revised guidelines on otitis media diagnosis and management led to decreases in antibiotic prescriptions, but those initial decreases have tapered off over the years, according to a study published online.
Sharon K. Greene, PhD, MPH, and colleagues from Harvard Medical School and Harvard Pilgrim Health Care in Boston looked at antibiotic prescription rates from Pilgrim and another insurer between 2000 and 2009. When comparing data from 2000 to 2001 and 2008 to 2009, the researchers noted antibiotic dispensing dropped 24% in children aged younger than 2 years, and 18% in those younger than 4 years. They noted that the largest reductions occurred by 2005, after the American Academy of Pediatrics (AAP) issued new guidelines on otitis media (OM) management, and the researchers noted those rates remained stable thereafter.
The researchers hypothesized that changes in vaccination practices, notably, a recommendation for universal influenza vaccination, together with increasing seven-valent pneumococcal conjugate vaccine (Prevnar, Pfizer) use during that time, combined with revised guidelines from the AAP about acute OM (AOM) diagnoses, “facilitated a changing culture of practice around AOM.”
The researchers reported, however, some study limitations, notably that their research used data from claims, which can contain limited demographic and clinical details. Regardless, Greene and colleagues said that their data should prompt further study of antibiotic trends.
“Trends in population-based dispensing rates should continue to be monitored in young children to determine if current rates are sustained, decrease further, or increase in ways that may suggest antibiotic overuse,” the researchers noted.
Disclosure: Dr. Greene reports no relevant financial disclosures.
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