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The burden of acute otitis media on the patient and the family

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The aim of our study was to determine the burden of acute otitis media (AOM) on patients and their families. Parents of children with AOM were interviewed with regard to the week preceding the AOM diagnosis and every 3 days henceforth for an additional 21 days. The interview included information on loss of workdays, use of health care services and impact on the patient's and family's quality of life. Parents of age- and neighbourhood-matched controls were interviewed in an identical manner. A total of 150 patients and 51 controls were included in the analysis. The following variables differed significantly ( P <0.001) between patients and controls (mean ± SD): non-routine days 18.5±11.0 in patients versus 3.4±6.5 in controls; number of visits to primary health centres 2.6±1.6 versus 0.4±0.6; number of emergency room visits 0.2±0.5 versus 0.1±0.02 and number of visits to an otolaryngology clinic 0.3±0.6 versus 0. Days of antibiotic and over the counter drug use were 9.0±5.6 versus 0.3± 0.9 and 7.0±6.0 versus 4.9±6.0, respectively per episode. The mean loss of workdays per child was 1.6±1.8 in patients versus 0.25±0.6 in controls, for working mothers and 0.6±1.1 versus 0.1±0.4 for working fathers; duration of absenteeism from day care facilities was 3.5±2.5 versus 0.9±2.7. Conclusion: Acute otitis media significantly reduces the quality of life of both child and parents, causes substantial use of medical services and significant loss of workdays.

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  1. Alsarraf R, Jung CJ, Perkins J, Crowley C, Alsarraf NW, Gates GA (1999) Measuring the indirect and direct costs of acute otitis media. Arch Otolaryngol Head Neck Surg 125: 12–18

    CAS  PubMed  Google Scholar 

  2. Bondy J, Berman S, Glazner J, Lezotte D (2000) Direct expenditures related to otitis media diagnoses: extrapolations from a pediatric medicaid cohort. Pediatrics 105:http://www/

  3. Capra AM, Lieu TA, Black SB, Shinefield HR, Martin KE, Klein JO (2000) Costs of otitis media in a managed care population. Pediatr Infect Dis J 19: 354–355

    Article  CAS  PubMed  Google Scholar 

  4. Carabin H, Gyorkos TW, Soto JC, Penrod J, Joseph L, Collet JP (1999) Estimation of direct and indirect costs because of common infections in toddlers attending day care centers. Pediatrics 103: 556–564

    CAS  PubMed  Google Scholar 

  5. Eskola J, Kilpi T, Palmu A, Jokinen J, Haapakoski J, Herva E, Takala A, Kayhty H, Karma P, Kohberger R, Siber G, Makela PH (2001) Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 344: 403–409

    PubMed  Google Scholar 

  6. Gates GA (1996) Cost-effectiveness considerations in otitis media treatment. Otolaryngol Head Neck Surg 11: 525–530

    Google Scholar 

  7. Huse DM, Meissner HC, Lacey MJ, Oster G (1994) Childhood vaccination against chickenpox: an analysis of benefits and costs. J Pediatr 124: 869–874

    CAS  PubMed  Google Scholar 

  8. Jacobs MR (2002) Prevention of otitis media: role of pneumococcal conjugate vaccines in reducing incidence and antibiotic resistance J Pediatr 141: 287–293

  9. Kaplan B, Wandstrat TL, Cunningham JR (1997) Overall cost in the treatment of otitis media. Pediatr Infect Dis J 16: S9–S11

    Article  CAS  PubMed  Google Scholar 

  10. Klein JO (1993) Microbiologic efficacy of antibacterial drugs for acute otitis media. Pediatr Infect Dis J 12: 973–975

    CAS  PubMed  Google Scholar 

  11. Lieu TA, Ray GT, Black SB, Butler JC, Klein JO, Breiman RF, Miller MA, Shinefield HR (2000) Projected cost-effectiveness of pneumococcal conjugate vaccination of healthy infants and young children. JAMA 283: 1460–1468

    CAS  PubMed  Google Scholar 

  12. Managed Care Advisory Panel (1999) Streptocococcus pneumoniae conjugate vaccine managed care advisory panel recommendations on Pnc7 and vaccine reimbursement guidelines. Am J Manag Care 5: S976–S980

    Google Scholar 

  13. Mortality and Morbidity Weekly Report (1997) Prevention of pneumococcal disease: Recommendations of the Advisory Committee on Immunization Practices. MMRW 46 (RR-8): 1–24

  14. Niemela M, Uhari M, Mottonen M, Pokka T (1999) Costs arising from otitis media. Acta Paediatr 88: 553–556

    Article  CAS  PubMed  Google Scholar 

  15. Nurmi T, Salminen E, Ponka A (1991) Infections and other illnesses of children in day-care centers in Helsinki. II. The economic losses. Infection 19: 331–335

    CAS  PubMed  Google Scholar 

  16. Weycker D, Richardson E, Oster G (2000) Childhood vaccination against pneumococcal otitis media and pneumonia: an analysis of benefits and costs. Am J Manag Care 6: S526–S535

    CAS  PubMed  Google Scholar 

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Correspondence to David Greenberg.

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Greenberg, D., Bilenko, N., Liss, Z. et al. The burden of acute otitis media on the patient and the family. Eur J Pediatr 162, 576–581 (2003).

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