Abstract
OBJECTIVE: To examine whether watchful waiting was an appropriate strategy for patients with earache, when there was no clear indication to prescribe antibiotics at the first visit. DESIGN: Case series of consecutive patients with unilateral earache. SETTING: Rural family practice clinic and walk-in centre. PARTICIPANTS: One hundred patients with unilateral earache. INTERVENTIONS: Patients who clearly needed antibiotic treatment were given it; others were advised about symptom relief and were followed up as necessary. MAIN OUTCOME MEASURES: Whether patients returned to the clinic, and whether antibiotics were subsequently prescribed. RESULTS: Two patients were prescribed antibiotics at the first visit. Of the remaining 98 people, only four returned to the clinic because of earache, and two of these were prescribed antibiotics. Thus, of 100 people with earache, four received antibiotic prescriptions. CONCLUSIONS: Most people who present to primary care physicians with earache do not need antibiotics for what appears to be a mostly self-limiting condition. Both physicians and patients should be educated about this.
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