Antibiotics for nasopharyngitis are associated with a lower risk of office-based physician visit for acute otitis media within 14 days for 3- to 6-year-old children

Authors

  • Jérôme Salomon,

    1. PhD Student, INSERM, U657, Paris, France and PhD Student, Centre de Ressources en Biostatistiques, Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses, Institut Pasteur, Paris, France and Chief of Unit, Public Health Unit, Department of Infectious Diseases, CHU Raymond Poincaré, Assistance Publique – Hôpitaux de Paris, Garches, France
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  • Agnès Sommet,

    1. PhD Student, INSERM, U657, Paris, France and PhD Student, Centre de Ressources en Biostatistiques, Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses, Institut Pasteur, Paris, France and Chief of Unit, Public Health Unit, Department of Infectious Diseases, CHU Raymond Poincaré, Assistance Publique – Hôpitaux de Paris, Garches, France
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  • Claire Bernède,

    1. PhD Student, INSERM, U657, Paris, France and PhD Student, Centre de Ressources en Biostatistiques, Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses, Institut Pasteur, Paris, France and Chief of Unit, Public Health Unit, Department of Infectious Diseases, CHU Raymond Poincaré, Assistance Publique – Hôpitaux de Paris, Garches, France
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  • Christine Tonéatti,

    1. PhD Student, INSERM, U657, Paris, France and PhD Student, Centre de Ressources en Biostatistiques, Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses, Institut Pasteur, Paris, France and Chief of Unit, Public Health Unit, Department of Infectious Diseases, CHU Raymond Poincaré, Assistance Publique – Hôpitaux de Paris, Garches, France
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  • Claude Carbon,

    1. PhD Student, INSERM, U657, Paris, France and PhD Student, Centre de Ressources en Biostatistiques, Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses, Institut Pasteur, Paris, France and Chief of Unit, Public Health Unit, Department of Infectious Diseases, CHU Raymond Poincaré, Assistance Publique – Hôpitaux de Paris, Garches, France
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  • Didier Guillemot

    1. PhD Student, INSERM, U657, Paris, France and PhD Student, Centre de Ressources en Biostatistiques, Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses, Institut Pasteur, Paris, France and Chief of Unit, Public Health Unit, Department of Infectious Diseases, CHU Raymond Poincaré, Assistance Publique – Hôpitaux de Paris, Garches, France
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Jérôme Salomon
Centre de Ressources en Biostatistiques
Epidémiologie et Pharmaco épidémiologie (CeRBEP) appliquées aux Maladies Infectieuses
INSERM U657
Institut Pasteur
25–28 rue du Docteur Roux
75 724 Paris Cedex 15
France
E-mail: jsalomon@pasteur.fr/
jerome.salomon@rpc.aphp.fr

Abstract

Objectives  This study was designed to analyse factors potentially influencing children's return visits to physicians for symptoms of acute otitis media (AOM) within 14 days after being diagnosed with nasopharyngitis (NP), and the impact of recent antibiotic use.

Design  A controlled population-based pharmaco-epidemiological trial in 3- to 6-year-old children conducted from January to May 2000.

Setting  Three different geographical regions in France.

Participants  Among 2507 eligible children, 2456 could be analysed and 505 children had 634 office-based physician visits (OBPV) for NP symptoms.

Interventions  The statistical associations between antibiotics prescribed for NP and an OBPV for AOM within 14 days in a population-based study were analysed along with risk factors of AOM.

Main outcomes measure  Clinical events and antibiotic use.

Results  During the 2 weeks following physician-diagnosed NP, antibiotic use, especially a beta-lactam, significantly decreased the risk of OBPV for AOM in children (odds ratio = 0.2; 95% confidence interval = 0.09–0.7; P = 0.002).

Conclusion  Antibiotics prescribed to children for NP seem to protect during the following 2 weeks against the risk of OBPV for AOM. It remains to be determined whether a subgroup at high risk of developing AOM after a viral infection exists and what might be the best strategy to adopt for NP in a national programme of optimal antibiotic use.

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