346 INCIDENCE AND MANAGEMENT OF ACUTE OTITIS MEDIA

Introduction. In the Netherlands the recommendations for treatment of acute otitis media imply more restrictive use of antibiotics than in other countries. We studied nationwide data on the incidence, treatment, and short-term follow up of acute otitis media in general practice.Methods. We used data from the “Dutch National Survey of Morbidity and Interventions in General Practice”, in which 161 GPs registered every contact between patient and practice during three months. Census data of the practice population (64000 children aged below 15) were collected. We selected all contacts with the provisional diagnosis acute otitis media.The overall incidence was 101 per 1000 personyears. The incidence was highest in 3 and 4 year old children and in the months January to March. We could follow the registered contacts of 1322 children for 1 month. Antibiotics (mainly oral penicillins) were prescribed to only 21% of the in the first contact. Children with fever or respiratory complaints received antibiotics more frequenly. In the rollow up recurrent otitis media (31%), glue-ear (5%), and chronic suppurative otitis media (1%) occurred. The registered contacts of the follow up month did pot show meningitis, mastoiditis, or cholesteatoma was observed during follow up.Conclusions. These data are in agreement with local studies published in the past. The data support the idea that a relative infrequent use of antibiotics even in children < 1 year, is not associated with a high frequency of complications.