Perinatal & Pediatric
Acute Otitis Media Treatment Among Children in the US Military Health System Chrystelle Kiang* Chrystelle Kiang Kiang Kiang Kiang Kiang Kiang Kiang Kiang Kiang Deployment Health Research Department, Naval Health Research Center
Background: Approximately 60% of children will experience at least 1 episode of acute otitis media (AOM), a middle ear infection, by age 3. AOM is the most common indication for antibiotic treatment in children and proper usage is necessary to prevent antibiotic resistance and risk of adverse events. We sought to characterize AOM treatment among US military-connected children.
Methods: This retrospective cohort study used Birth and Infant Health Research program data to identify children born between March 2013 and June 2021, with follow-up until age 5 or September 2024. We obtained diagnosis and treatment records from administrative medical encounter data and evaluated concordance with American Academy of Pediatrics guidelines among those treated with antibiotics. Guideline-concordant 1st line treatment was amoxicillin for 10 days for those <2 years and 7 days for ≥2 years. We summarized guideline concordance by child, parental, and provider characteristics.
Results: During the study period, 418,896 children had at least 1 outpatient AOM diagnosis and were prescribed an oral antibiotic. For children ages 6 months–2 years old, 68% were prescribed amoxicillin for 10 days. For children 2–5 years old, only 7% were prescribed amoxicillin for the recommended 7 days while 64% were prescribed amoxicillin for 10 days, and the remaining 29% were prescribed non-guideline concordant antibiotics. There were no meaningful differences by child, parent, and provider characteristics.
Conclusion: While most children in our study were prescribed the guideline-concordant agent of amoxicillin, those aged 2–5 were likely to have a non-concordant duration and receive an oversupply. This inappropriate use of antibiotics may lead to adverse outcomes and antimicrobial resistance.