Parents may be giving physicians an earful about a new guideline calling for selective use of antibiotics to treat acute otitis media in children ages 6 months to 12 years.
Treating an ear infection is a multifaceted issue, and evidence has shown that most cases resolve without antibiotic use, said Martin Mahoney, M.D., past chair of the AAFP Commission on Clinical Policies and Research and a member of the joint guideline panel of the AAFP and American Academy of Pediatrics.
It was important for FPs and pediatricians to collaborate on this guideline, Mahoney said. "It makes a lot of sense for medical specialty societies who treat the same population of patients to work together on guidelines. It sends a unified message to the public and to physicians. We can be assured that a large population of children can be cared for in a way that is supported by the evidence."
Treatment of AOM has been such a contentious issue that the lay press began publicizing the guideline before it was formally approved March 9. There was so much misinformation circulating, the groups released the guideline ahead of schedule.
Much early press coverage had focused on the recommendation regarding antibiotic use, excluding mention of pain relief.
Angry parents reacted. "You people are always trying to change things because of your 'opinions' ... come back to the real world," one mother wrote to the AAP.
In fact, the guideline states that AOM management should include treatment for pain, if present. Mahoney says careful counseling should alleviate confusion.
"If you step through the guideline in a logical way with parents, by the time you get to the end, a light bulb should go off," he said. "We're not saying 'don't prescribe antibiotics,' but there are certain things you can do: You can have close follow-up, or you can have an emergency prescription to use if the condition doesn't improve."
The guideline, available at http://www.aafp.org/x26481.xml, includes Q-and-A materials for physicians and parents.
To reach writer Toni Lapp, e-mail tlapp@aafp.org.
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