Demographic Influences on Antibiotic Prescribing for Pediatric Acute Otitis Media

Abstract

Objective. To understand the epidemiologic antibiotic treatment patterns and the potential impact of race and insurance status on the medical management of acute otitis media (AOM).Study Design. Cross-sectional analysis of a national database.Setting. National ambulatory care setting.Methods. Cases of isolated AOM in children ≤16.0 years were extracted from the National Ambulatory Medical Care Survey (2006-2008). The frequency and type of antibiotic prescribed were extracted. A multivariate logistic regression model incorporating age, sex, race, ethnicity, and insurance type was used to determine the influence of these demographic variables on antibiotic prescribing patterns.Results. A total of 15.8 ± 1.5 million cases of AOM were studied (mean age, 3.6 ± 0.3 years; 55.1% ± 2.9% male). Of the children, 15.0% ± 2.8% were Hispanic and 10.4% ± 3.1% were black. Medicaid/State Children’s Health Insurance Program and private insurance covered 30.6% ± 4.4% and 69.4% ± 4.4% of children, respectively. Overall, 83.1% ± 2.2% of children received an antibiotic prescription. The most commonly prescribed antibiotics were amoxicillin (6.5 ± 0.9 million), beta-lactamase inhibitors (2.6 ± 0.4 million), and third-generation cephalosporins (2.3 ± 0.4 million prescriptions). On multivariate analysis, insurance status, ethnicity, race, age, and sex did not influence the likelihood of an antibiotic being prescribed during the visit ( P = .884, .909, .849, .102, and .931 respectively).Conclusions. Most children receiving medical treatment for AOM receive an antibiotic prescription during their visit. Ethnicity, race, and insurance type do not significantly influence antibiotic prescribing rates for AOM, and nearly all patients have medical insurance.