Antibiotic Treatment of Otitis Media May Not Prevent Mastoiditis

Antibiotic Treatment of Otitis Media May Not Prevent Mastoiditis

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Expires: February 24, 2010

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The introductory paragraph of this CME program quotes the authors of a study that appeared in the February 2009 issue of Pediatrics, who wrote that “Ecological studies of routine health care databases have suggested that the reduction in antibiotic prescribing to children may be associated with an increase in rare complications of bacterial infection, particularly mastoiditis after otitis media. Individual patient level analyses are now required."

Thus, Paula Louise Thompson, BSc, MSc Epid, from the University of London, United Kingdom, and colleagues designed a study to “examine time trends in mastoiditis incidence, the frequency of preceding otitis media, and the effect of antibiotics for otitis media on the subsequent risk for mastoiditis in children.”

This CME activity is based on the results of that study. It is intended for pediatricians and other primary care clinicians, otolaryngologists, infectious disease specialists, and other specialists who care for children with otitis media. It describes the effect of antibiotics for otitis media on the subsequent risk for mastoiditis in children and discusses the association between otitis media and mastoiditis incidence in the UK General Practice Research Database.

Based on their results, the authors of the study discussed here concluded that general practitioners and pediatricians working in primary care “need to be able to recognize the signs of mastoiditis (postauricular swelling and protrusion of the auricle), particularly in older children, and to refer promptly to ENT [ear, nose, and throat] services. They also advised that "trends in antibiotic prescribing need to be formally monitored in association with the longitudinal follow-up of individual patient disease outcomes data, to ensure that any changes in antibiotic use are not causing harm."

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