Child/Adolescent Health

Less than half of consumer Web sites are updated to reflect new recommendations on antibiotic use for ear infections

Ear infections (acute otitis media, AOM) are the leading cause of antibiotic use among children in the United States. Updated recommendations for treating AOM include a "watch and wait" strategy for certain patients before prescribing antibiotics as well as a recommendation to finish the full course of antibiotics. The goal of the updates was to reduce unnecessary use of antibiotics, which has contributed to the rise in antibiotic-resistant infections. However, only 31 percent of relevant Web sites searched by the authors of this study explained the new "watch and wait" recommendation, and only 41 percent included the need to finish the full course of prescribed antibiotics; 14 percent of Web sites included both recommendations.

Doctors should be aware that patients may have unrealistic expectations about antibiotic prescriptions based on visits to Web sites and should educate them about where they can find reliable online information, recommend the study authors. They reviewed 105 relevant Web sites out of 400 found that were through search engines to determine if consumers were likely to find the recent recommendations about use of antibiotics for AOM. Overall, fewer than one-third of the relevant Web sites were appropriately updated in the 32 months after the new recommendations for a watch and wait option were published. Only half of these included the additional recommendation to finish the full course of antibiotics.

The Web sites with the appropriate recommendations were two to three times more likely to have a listed update, to have been written or reviewed by a physician, to cite the source of the recommendation, to have a non-profit-type domain, to have an easier reading score, or to have been updated within the past year.

The study was supported by the Agency for Healthcare Research and Quality (T32 HS00044).

See "Appropriate antibiotic use for acute otitis media: What consumers find using Web searches," by Margaret L. Holland, M.S., and Maria Fagnano, B.A., in the June 2008 Clinical Pediatrics 47(5), pp. 452-456.

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