{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T09:57:06Z","timestamp":1783504626056,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Acute otitis media (AOM) is a common indication for antibiotics in children. We sought to characterize the frequency of nonguideline concordant antibiotic therapy for AOM in the United States, by agent and duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using national administrative claims data (2016\u20132019), we identified children aged 6\u00a0months to 17\u2009years with an oral antibiotic dispensed within 3\u2009days of a new diagnosis of suppurative AOM. Use of nonguideline concordant agents and durations, defined based on national treatment guidelines, were summarized by age, race, rurality, region, and insurance type. Subsequent oral antibiotic dispensing within the year after AOM diagnosis was also evaluated. We created sunburst diagrams to visualize longitudinal patterns of within\u2010person antibiotic utilization for AOM, by agent and duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 789\u2009424 eligible commercially\u2010insured and 502\u2009239 medicaid\u2010insured children. Among commercially insured children, 35% received nonguideline concordant agents for AOM, including cefdinir (16%), amoxicillin\u2010clavulanate (12%), and azithromycin (7%). Fewer children age\u2009&lt;2\u2009years received a nonguideline concordant initial agent (27%) compared to age\u2009\u22656\u2009years (41%). More children age\u2009&lt;2\u2009years received three or more antibiotics over the following year (34% vs. 3% for children age\u2009\u22656\u2009years). The most common treatment duration was 10\u2009days for all ages; treatment duration for the initial antibiotic was nonguideline concordant for 95% and 89% of children age 2\u20135\u2009years and\u2009\u22656\u2009years, respectively. Patterns were similar for medicaid\u2010insured children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nonguideline concordant antibiotic use is common when treating AOM in children, including use of broad\u2010spectrum agents and longer\u2010than\u2010recommended antibiotic durations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5554","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T12:19:58Z","timestamp":1666354798000},"page":"256-265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Utilization of nonguideline concordant antibiotic treatment following acute otitis media in children in the <scp>U<\/scp>nited <scp>S<\/scp>tates"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0312-635X","authenticated-orcid":false,"given":"Leah J.","family":"McGrath","sequence":"first","affiliation":[{"name":"Inferential 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