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Acute otitis media (AOM) is the leading reason for antibiotic prescription to children. Studies based in office practices have shown that a “wait-and-see prescription” (WASP) for antibiotics, in which parents fill the prescription only if symptoms have not improved in 48 hours, has no deleterious effects in children with nonsevere AOM. Now, investigators have studied this strategy in a pediatric emergency department setting, where patients have no ongoing relationship with the clinician.
During 2004–2005, 283 children aged 6 months to 12 years seen with AOM at a Connecticut emergency department were randomized to receive either a WASP or a standard prescription (SP). Children who appeared “toxic” or had systemic symptoms or comorbidity were …