{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T17:40:04Z","timestamp":1791654004068,"version":"4.3.4"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Previous research suggests that physicians may be less likely to diagnose otitis media (OM) and to prescribe broad-spectrum antibiotics for black versus nonblack children. Our objective was to determine whether race is associated with differences in OM diagnosis and antibiotic prescribing nationally.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We examined OM visit rates during 2008 to 2010 for children \u226414 years old using the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. We compared OM visits between black and nonblack children, as percentages of all outpatient visits and visit rates per 1000. We compared antibiotic prescribing by race as the percentage of OM visits receiving narrow-spectrum (eg, amoxicillin) versus broader-spectrum antibiotics. We used multivariable logistic regression to examine whether race was independently associated with antibiotic selection for OM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The percentage of all visits resulting in OM diagnosis was 30% lower in black children compared with others (7% vs 10%, P = .004). However, OM visits per 1000 population were not different between black and nonblack children (253 vs 321, P = .12). When diagnosed with OM during visits in which antibiotics were prescribed, black children were less likely to receive broad-spectrum antibiotics than nonblack children (42% vs 52%, P = .01). In multivariable analysis, black race was negatively associated with broad-spectrum antibiotic prescribing (adjusted odds ratio 0.59; 95% confidence interval, 0.40\u20130.86).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Differences in treatment choice for black children with OM may indicate race-based differences in physician practice patterns and parental preferences for children with OM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-1781","type":"journal-article","created":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T02:42:23Z","timestamp":1416278543000},"page":"1059-1066","source":"Crossref","is-referenced-by-count":75,"title":["Race, Otitis Media, and Antibiotic Selection"],"prefix":"10.1542","volume":"134","author":[{"given":"Katherine E.","family":"Fleming-Dutra","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauri A.","family":"Hicks","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam L.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,12,1]]},"reference":[{"issue":"11","key":"2021120906552864600_B1","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.3201\/eid1411.070467","article-title":"Antimicrobial drug use and resistance in Europe.","volume":"14","author":"van de Sande-Bruinsma","year":"2008","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"2021120906552864600_B2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jpeds.2003.10.053","article-title":"Differences in antibiotic prescribing patterns for children younger than five years in the three major outpatient settings.","volume":"144","author":"Halasa","year":"2004","journal-title":"J Pediatr"},{"issue":"5","key":"2021120906552864600_B3","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1542\/peds.113.5.1451","article-title":"Diagnosis and management of acute otitis media.","volume":"113","author":"American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media","year":"2004","journal-title":"Pediatrics"},{"issue":"3","key":"2021120906552864600_B4","article-title":"The diagnosis and management of acute otitis media [published correction appears in Pediatrics. 2014;133(2):346].","volume":"131","author":"Lieberthal","year":"2013","journal-title":"Pediatrics"},{"issue":"4","key":"2021120906552864600_B5","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1542\/peds.2012-2500","article-title":"Racial differences in antibiotic prescribing by primary care pediatricians.","volume":"131","author":"Gerber","year":"2013","journal-title":"Pediatrics"},{"issue":"11","key":"2021120906552864600_B6","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1002\/lary.21090","article-title":"Racial\/ethnic and socioeconomic disparities in the prevalence and treatment of otitis media in children in the United States.","volume":"120","author":"Smith","year":"2010","journal-title":"Laryngoscope"},{"issue":"2","key":"2021120906552864600_B7","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1542\/peds.2009-1115","article-title":"Management of acute otitis media after publication of the 2004 AAP and AAFP clinical practice guideline.","volume":"125","author":"Coco","year":"2010","journal-title":"Pediatrics"},{"key":"2021120906552864600_B8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1471-2431-9-41","article-title":"Trends in broad-spectrum antibiotic prescribing for children with acute otitis media in the United States, 1998\u20132004.","volume":"9","author":"Coco","year":"2009","journal-title":"BMC Pediatr"},{"issue":"4","key":"2021120906552864600_B9","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1177\/0194599811431228","article-title":"Demographic influences on antibiotic prescribing for pediatric acute otitis media.","volume":"146","author":"Sidell","year":"2012","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2021120906552864600_B10","unstructured":"Centers for Disease Control and Prevention. Ambulatory health care data. 2012. Available at: www.cdc.gov\/nchs\/ahcd.htm. 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