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Paul Little, MBBS, MD, FRCGP

JAMA. 2006;296:1290-1291.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Based on experience in Holland,¹ evidence from systematic reviews,² and recent evidence in the United Kingdom,³ many northern European countries, including the United Kingdom, have developed guidelines to advise physicians to delay for a short time before prescribing antibiotics for children with acute otitis media (AOM).⁴ The Dutch developed a policy of no prescription for AOM unless the patient has significant otalgia, fever, or both 72 hours after seeing the physician, or if a prolonged otic discharge develops.⁵ One study showed that if this watchful-waiting approach is used, there are likely to be few cases of complications (only 1 case of mastoiditis occurred in a 5000-patient cohort, and this patient had waited nearly a week).¹ Patients and their families should be given clear advice about returning to see their physician if signs of complications occur, ie, worsening systemic features such as fever or vomiting.

The . . . [Full Text of this Article]

Author Affiliations: Community Clinical Sciences Division, University of Southampton, Aldermoor Health Centre, Southampton, United Kingdom.

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