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Antibiotic script delays backed in otitis media

GPs should delay prescribing of antibiotics for otitis media as the strategy has no medium- or long-term adverse effects, researchers conclude.

Their trial found delaying scripts had no effect on epi-sodes of earache, or functions such as speech or reading ability, up to a year after treatment.

A companion study in March's British Journal of General Practice found prescribing anti-biotics increased rates of reattendance for acute otitis media by 9 per cent.

Together, the studies strengthen suggestions first made in 2001 that delaying scripts can cut antibiotic use without put-ting children at risk.

Professor Paul Little, a researcher on both studies and leader of the first, said: 'For most children, delayed prescribing is not likely to have longer-term consequences.'

Professor Little, professor of primary care research at the University of Southampton and a part-time GP, evaluated the effect of immediate or delayed antibiotics in 315 children aged six months to 10 years.

There was some evidence delayed scripts might harm function in children with recurrent otitis media, with an 86 per cent increase in 'poor function' at one year. But a secondary analysis suggested immediate antibiotic use had no long-term benefits.

Professor Little advised: 'Children who vomit and who have a pyrexia over 37.5 on examination are slightly more likely to benefit from antibiotics in the short-term, so it is reasonable to advise a shorter wait and see policy.'

Dr Ian Williamson, who led the second study, said: 'When you prescribe antibiotics you are making a rod for your own back and increasing practice workload ­ it medicalises the condition.'

Dr Williamson, who is a senior lecturer in primary medical care at the University of Southampton, added: 'The evidence doesn't support [antibiotic] use in the majority of ear infections but people still expect them. Delayed prescribing means the doctor doesn't have to get into a contest of wills.'

The research comes as a third study is due to report there is no cause for concern over fears that reduced antibiotic use is fuel-ling rising rates of mastoiditis.

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