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Article: Has UK guidance affected general practitioner antibiotic prescribing for otitis media in children?

TitleHas UK guidance affected general practitioner antibiotic prescribing for otitis media in children?
Authors
KeywordsChildren
Ear disorders
Epidemiology
Issue Date2008
PublisherOxford University Press. The Journal's web site is located at http://jpubhealth.oxfordjournals.org/
Citation
Journal Of Public Health, 2008, v. 30 n. 4, p. 479-486 How to Cite?
AbstractBackgroundSince 1997, UK guidance has advocated limiting antibiotic prescribing for otitis media. It is not known whether this has influenced general practitioner prescribing practice.Aims and objectivesTo investigate the trends in diagnoses and antibiotic prescribing for otitis media in children in relation to guidance.MethodsWe used the General Practice Research Database to conduct time-trend analyses of diagnoses and antibiotic prescribing for otitis media in 3 months to 15 years old, between 1990 and 2006.ResultsA total of 1 210 237 otitis media episodes were identified in 464 845 children; two-thirds (68; 818 006) received antibiotics. Twenty-two percent (267 335) were classified as acute, 85 (227 335) of which received antibiotics. Overall, antibiotic prescribing for otitis media declined by 51 between 1995 and 2000. Much of this reduction predated guidance. During this period, prescribing for otitis media coded as acute increased by 22. Children diagnosed with acute otitis media were more likely to receive antibiotics than otitis media not coded as acute (P < 0.05). From 2000 prescribing plateaued, despite publication of further guidance. Otitis media diagnoses consistently paralleled prescribing.ConclusionsThe reduction in antibiotic prescribing for otitis media predated guidance. The simultaneous decrease in prescribing for non-acute otitis media and increase for acute otitis media suggest diagnostic transfer, possibly to justify the decision to treat. © The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/132923
ISSN
2015 Impact Factor: 2.019
2015 SCImago Journal Rankings: 0.933
ISI Accession Number ID
Funding AgencyGrant Number
Department of Health Public Health Career Scientist Award
Department of Health
European Commission
Funding Information:

I. C. K. W.'s post was funded by the Department of Health Public Health Career Scientist Award. S. S. holds a National post doctoral award from the Department of Health. The license for the GPRD was funded by the European Commission via the Taskforce in Europe for Drug Development for the Young (TEDDY) network of Excellence European Commission Framework 6 Programme, 2005 - 10. All researchers were independent from the funders.

References

 

DC FieldValueLanguage
dc.contributor.authorThompson, PLen_HK
dc.contributor.authorGilbert, REen_HK
dc.contributor.authorLong, PFen_HK
dc.contributor.authorSaxena, Sen_HK
dc.contributor.authorSharland, Men_HK
dc.contributor.authorWong, ICKen_HK
dc.date.accessioned2011-04-04T07:58:00Z-
dc.date.available2011-04-04T07:58:00Z-
dc.date.issued2008en_HK
dc.identifier.citationJournal Of Public Health, 2008, v. 30 n. 4, p. 479-486en_HK
dc.identifier.issn1741-3842en_HK
dc.identifier.urihttp://hdl.handle.net/10722/132923-
dc.description.abstractBackgroundSince 1997, UK guidance has advocated limiting antibiotic prescribing for otitis media. It is not known whether this has influenced general practitioner prescribing practice.Aims and objectivesTo investigate the trends in diagnoses and antibiotic prescribing for otitis media in children in relation to guidance.MethodsWe used the General Practice Research Database to conduct time-trend analyses of diagnoses and antibiotic prescribing for otitis media in 3 months to 15 years old, between 1990 and 2006.ResultsA total of 1 210 237 otitis media episodes were identified in 464 845 children; two-thirds (68; 818 006) received antibiotics. Twenty-two percent (267 335) were classified as acute, 85 (227 335) of which received antibiotics. Overall, antibiotic prescribing for otitis media declined by 51 between 1995 and 2000. Much of this reduction predated guidance. During this period, prescribing for otitis media coded as acute increased by 22. Children diagnosed with acute otitis media were more likely to receive antibiotics than otitis media not coded as acute (P < 0.05). From 2000 prescribing plateaued, despite publication of further guidance. Otitis media diagnoses consistently paralleled prescribing.ConclusionsThe reduction in antibiotic prescribing for otitis media predated guidance. The simultaneous decrease in prescribing for non-acute otitis media and increase for acute otitis media suggest diagnostic transfer, possibly to justify the decision to treat. © The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://jpubhealth.oxfordjournals.org/en_HK
dc.relation.ispartofJournal of Public Healthen_HK
dc.subjectChildrenen_HK
dc.subjectEar disordersen_HK
dc.subjectEpidemiologyen_HK
dc.titleHas UK guidance affected general practitioner antibiotic prescribing for otitis media in children?en_HK
dc.typeArticleen_HK
dc.identifier.emailWong, ICK: wongick@hku.hken_HK
dc.identifier.authorityWong, ICK=rp01480en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1093/pubmed/fdn072en_HK
dc.identifier.pmid18765405-
dc.identifier.scopuseid_2-s2.0-56749178861en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-56749178861&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue4en_HK
dc.identifier.spage479en_HK
dc.identifier.epage486en_HK
dc.identifier.eissn1741-3850-
dc.identifier.isiWOS:000261170300024-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridThompson, PL=25923668200en_HK
dc.identifier.scopusauthoridGilbert, RE=7401932225en_HK
dc.identifier.scopusauthoridLong, PF=7201512275en_HK
dc.identifier.scopusauthoridSaxena, S=12774236400en_HK
dc.identifier.scopusauthoridSharland, M=7006566942en_HK
dc.identifier.scopusauthoridWong, ICK=7102513915en_HK
dc.identifier.citeulike4368260-

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