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Wait-and-See approach to Earaches

"Up to 2 million people 140,000 die each year reactions to prescription drugs, on Food and Drug Administration data."

USA Today, January 3



For many MDs, the first response to childhood acute otitis media (AOM) is a signed prescription for any one of the many
antibiotics currently available. The frequency of past infections or the urgency of the current one do not seem to go into
their decision. This automatic response has spurred some researchers to explore alternatives to the "take this every six
hours" treatment. A recent study by the American Medical Association shows that the wait-and-see prescription (WASP)
approach could create a reduction in the overprescription of antibiotics.


The year-long trial was conducted on 283 children between the ages 6 and 12 who were randomly selected for either the
WASP group or the control group at the Yale-New Haven Hospital in New Haven, Conn. After the diagnosis of AOM was
made, the children in the control group were given a standard prescription for an antibiotic that would expire in three days.
The parents of children in the WASP group were also given similar prescriptions, but were told not to fill them unless their
child did not show improvement within 48 hours.


In the WASP group, 62 percent of the parents did not fill the prescriptions, compared to only 13 percent in the control
group. The researchers concluded that the WASP approach could substantially reduce the unnecessary use of
antibiotics in children.


Resource:
Spiro D, Tay K, Arnold D, et al. Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled
trial. Journal of the American Medical Association 2006;296(10):1235-1241.

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