{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:29:16Z","timestamp":1793845756704,"version":"4.6.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      (1) To evaluate the probability of antibiotic administration associated with\n                      <jats:italic>ICD\u20109<\/jats:italic>\n                      diagnosis of otitis media with effusion (OME) in the absence of acute otitis media, (2) to determine whether usage varies according to visit setting, and (3) to ascertain if practice gaps are such that future practice changes might be measured.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional analysis of an administrative database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Ambulatory visits in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005\u20102010; univariate, multivariate, and stratified analyses of antibiotic usage were performed. The study population was restricted to children without acute or unspecified otitis media. The primary outcome was the probability of oral antibiotic administration when OME was diagnosed. The impact of the location of service and subspecialty care was also analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 1,390,404,196 pediatric visits demonstrated that oral antibiotics were administered for 32% of visits with an OME diagnosis, even in the absence of acute otitis media (odds ratio, 4.31; 95% confidence interval: 2.88\u20106.44;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 001). The highest antibiotic administration was seen in the emergency department (risk difference, 37.1%; number needed to harm, 3). No significant increased risk of antibiotic usage was seen during otolaryngology visits. Diagnoses of infections at nonotologic sites were associated with a 1.98 to 26.60\u00a0increase in odds of oral antibiotic administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oral antibiotics continue to be administered in children with OME in the absence of acute infection, with risk varying by location of service. There is a potential opportunity for quality improvement through reducing antibiotic administration for pediatric OME.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0194599816633457","type":"journal-article","created":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T22:13:59Z","timestamp":1456870439000},"page":"797-803","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Oral Antibiotic Use for Otitis Media with Effusion"],"prefix":"10.1002","volume":"154","author":[{"given":"Rachel E.","family":"Roditi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Carrie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Calgary Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Bellmunt","sequence":"additional","affiliation":[{"name":"Ear Nose Throat Department Hospital Universitari de la Vall d\u2019Hebron Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Rosenfeld","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology SUNY Downstate Medical Center Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"359","article-title":"Quality of life and psycho\u2010social development in children with otitis media with effusion","volume":"25","author":"Bellussi L","year":"2005","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_10_3_1","first-page":"459","article-title":"Epidemiology and natural history of secretory otitis","volume":"5","author":"Tos M","year":"1984","journal-title":"Am J Otol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S0140-6736(89)91317-2","article-title":"Screening for otitis media with effusion in preschool children","volume":"1","author":"Zielhuis GA","year":"1989","journal-title":"Lancet"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1288\/00005537-198504000-00011","article-title":"Otitis media with effusion in preschool children","volume":"95","author":"Casselbrant ML","year":"1985","journal-title":"Laryngoscope"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1177\/147323001103900320","article-title":"Otitis media with effusion in primary schools in Princes\u2019 Islands, Istanbul: prevalence and risk factors","volume":"39","author":"Aydemir G","year":"2011","journal-title":"J Int Med Res"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.amjoto.2010.08.002","article-title":"Otitis media with effusion with or without atopy: audiological findings on primary schoolchildren","volume":"32","author":"Martines F","year":"2011","journal-title":"Am J Otolaryngol"},{"key":"e_1_2_10_8_1","volume-title":"Evidence\u2010Based Otitis Media","author":"Rosenfeld RM","year":"2003"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1542\/peds.83.4.477","article-title":"Otitis media in early childhood and cognitive, academic, and classroom performance of the school\u2010aged child","volume":"83","author":"Roberts JE","year":"1989","journal-title":"Pediatrics"},{"key":"e_1_2_10_10_1","unstructured":"US Department of Health and Human Services.2012 annual progress report to congress national strategy for quality improvement in health care: corrected August 2012 and May 2014.http:\/\/www.ahrq.gov\/workingforquality\/nqs\/nqs2012annlrpt.pdf. 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