Burden of acute otitis media on Canadian families

Eve Dubé; Philippe De Wals; Vladimir Gilca; Nicole Boulianne; Manale Ouakki; France Lavoie; Richard Bradet

Compose eLetter

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

Vertical Tabs

Jump to comment:

Letter to the Editor
M. Shirley Gross M.D., C.M., C.C.F.P

Published on: 01 March 2011
response re aom article
Sonya Regehr

Published on: 02 February 2011
AOM
Sobia F. Awan

Published on: 31 January 2011
Parental Education
Cheryl L Smits

Published on: 26 January 2011

Published on: (1 March 2011)

Letter to the Editor
M. Shirley Gross M.D., C.M., C.C.F.P, Director
Other Contributors:
We have read your article “Burden of acute otitis media (AOM) on Canadian families”, printed in the January 2011 edition of the Canadian Family Physician. The topic is certainly a valid line of scientific enqiry and the results are of interest to family physicians.
You have also chosen to mention primary prevention of AOM through immunization and note that this is an area requiring further study. It is curious...
Show More

We have read your article “Burden of acute otitis media (AOM) on Canadian families”, printed in the January 2011 edition of the Canadian Family Physician. The topic is certainly a valid line of scientific enqiry and the results are of interest to family physicians.
You have also chosen to mention primary prevention of AOM through immunization and note that this is an area requiring further study. It is curious that there was no further discussion of the other proven methods of primary prevention of AOM. Breastfeeding, in particular, is extremely well-studied and effective. One large meta-analysis showed that the pooled odds ration was 0.05 (95%CI.36-.70) when comparing exclusive breastfeeding with exclusive bottle-feeding, either for more than 3 or 6 months duration.
Other risk factors for AOM, including second hand smoke, child care attendance and pacifier use, were similarly neglected. This oversight, while puzzling initially, was quickly explained by the fine print.
“This sudy was supported by an unrestricted research grant from GlaxoSmithKline.” GlaxoSmithKline are of course, purveyors of vaccines. We would have expected better from the authors and from this journal.
Sincerely,
M. Shirley Gross M.D., C.M., C.C.F.P Director, Edmonton Breastfeeding Clinic Assistant Clinical Professor Department of Obstetrics and Gynaecology and of family Medicine University of Alberta Angela Berg M.C., C.C.F.P Edmonton Breastfeeding Clinic
1. Breast feeding and Maternal and Infant Health Outcomes in Developed Countries, Structured Abstract. May 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/brfouttp.htm
Show Less

Competing Interests: None declared.
Published on: (2 February 2011)

response re aom article
Sonya Regehr, family doctor
I was surprised percent of patients receiving antibiotics did not vary with age.

Competing Interests: None declared.
Published on: (31 January 2011)

AOM
Sobia F. Awan, Physician
I agree with Dr. Smits. I have taken a similar approach in my practice and after discussion with parents most agree to wait and see before starting antibiotics for AOM. I usually offer them the choice between either bringing the child back if not improving or to take home a prescription and fill it after a waiting period. I find most parents appreciate this approach.

Competing Interests: None declared.
Published on: (26 January 2011)

Parental Education
Cheryl L Smits, Family Physician
I have found that with AOM episodes in my clinic, it is effective to educate parents about the wait-and-see approach. Many parents these days are actually more reluctant to start their children on medication, and are open to waiting (as long as they have reassurance). If a parent decides to opt for the wait-and-see approach, I will usually give them a prescription to take with them, and to fill and administer should the chi...
Show More

I have found that with AOM episodes in my clinic, it is effective to educate parents about the wait-and-see approach. Many parents these days are actually more reluctant to start their children on medication, and are open to waiting (as long as they have reassurance). If a parent decides to opt for the wait-and-see approach, I will usually give them a prescription to take with them, and to fill and administer should the child worsen. This way, they do not have to be further burdened by returning for another visit should the condition change. I wonder if a study has been done to see if, in this situation, what percentage of parents who have decided to wait and see, but are able to take home a prescription (a safety net), actually end up filling it. If not, I think it would be an interesting study to do!
Show Less

Competing Interests: None declared.