Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 2000 May;46:1081–1084.

One hundred earaches. Family practice case series.

G Worrall 1
PMCID: PMC2144906  PMID: 10845134

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.

Full text

PDF
1084

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Elden L. M., Coyte P. C. Socioeconomic impact of otitis media in North America. J Otolaryngol. 1998;27 (Suppl 2):9–16. [PubMed] [Google Scholar]
  2. Froom J., Culpepper L., Jacobs M., DeMelker R. A., Green L. A., van Buchem L., Grob P., Heeren T. Antimicrobials for acute otitis media? A review from the International Primary Care Network. BMJ. 1997 Jul 12;315(7100):98–102. doi: 10.1136/bmj.315.7100.98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Hutchinson J. M., Foley R. N. Method of physician remuneration and rates of antibiotic prescription. CMAJ. 1999 Apr 6;160(7):1013–1017. [PMC free article] [PubMed] [Google Scholar]
  4. McIsaac W. J., White D., Tannenbaum D., Low D. E. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998 Jan 13;158(1):75–83. [PMC free article] [PubMed] [Google Scholar]
  5. Nyquist A. C., Gonzales R., Steiner J. F., Sande M. A. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998 Mar 18;279(11):875–877. doi: 10.1001/jama.279.11.875. [DOI] [PubMed] [Google Scholar]
  6. Pennie R. A. Prospective study of antibiotic prescribing for children. Can Fam Physician. 1998 Sep;44:1850–1856. [PMC free article] [PubMed] [Google Scholar]
  7. Rosenfeld R. M., Vertrees J. E., Carr J., Cipolle R. J., Uden D. L., Giebink G. S., Canafax D. M. Clinical efficacy of antimicrobial drugs for acute otitis media: metaanalysis of 5400 children from thirty-three randomized trials. J Pediatr. 1994 Mar;124(3):355–367. doi: 10.1016/s0022-3476(94)70356-6. [DOI] [PubMed] [Google Scholar]
  8. Seppälä H., Klaukka T., Vuopio-Varkila J., Muotiala A., Helenius H., Lager K., Huovinen P. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. Finnish Study Group for Antimicrobial Resistance. N Engl J Med. 1997 Aug 14;337(7):441–446. doi: 10.1056/NEJM199708143370701. [DOI] [PubMed] [Google Scholar]
  9. Stephenson J. Icelandic researchers are showing the way to bring down rates of antibiotic-resistant bacteria. JAMA. 1996 Jan 17;275(3):175–175. [PubMed] [Google Scholar]
  10. Swartz M. N. Use of antimicrobial agents and drug resistance. N Engl J Med. 1997 Aug 14;337(7):491–492. doi: 10.1056/NEJM199708143370709. [DOI] [PubMed] [Google Scholar]
  11. Teele D. W., Klein J. O., Rosner B., Bratton L., Fisch G. R., Mathieu O. R., Porter P. J., Starobin S. G., Tarlin L. D., Younes R. P. Middle ear disease and the practice of pediatrics. Burden during the first five years of life. JAMA. 1983 Feb 25;249(8):1026–1029. [PubMed] [Google Scholar]
  12. van Buchem F. L., Peeters M. F., van 't Hof M. A. Acute otitis media: a new treatment strategy. Br Med J (Clin Res Ed) 1985 Apr 6;290(6474):1033–1037. doi: 10.1136/bmj.290.6474.1033. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES