GP Vivas · child-and-youth-health
Otitis media in children — structured viva
Structured oral on childhood otitis media: defending watchful waiting with Cochrane numbers, the under-2 bilateral exception, dosing and duration rules, grommet criteria, and the complications that must not be missed.
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Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Parents demand antibiotics for ear infections; your colleagues hand them out like lollies. Defend your practice.' The viva branches through the trial evidence, the exceptions, the surgery question and the red flags.
Stem
You are the GP. A colleague says refusing antibiotics for ear infections is 'just cost-cutting'. [1]
References6ShowHide
- [1]Venekamp RP, Sanders SL, Glasziou PP, et al. Antibiotics for acute otitis media in children Cochrane Database Syst Rev, 2023.PMID 37965923
- [2]Hoberman A, Paradise JL, Rockette HE, et al. Treatment of acute otitis media in children under 2 years of age N Engl J Med, 2011.PMID 21226576
- [3]Hoberman A, Paradise JL, Rockette HE, et al. Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children N Engl J Med, 2016.PMID 28002709
- [4]Marchetti F, Ronfani L, Nibali SC, et al. Delayed prescription may reduce the use of antibiotics for acute otitis media: a prospective observational study in primary care Arch Pediatr Adolesc Med, 2005.PMID 15997003
- [5]Venekamp RP, Mick P, Schilder AG, et al. Grommets (ventilation tubes) for recurrent acute otitis media in children Cochrane Database Syst Rev, 2018.PMID 29741289
- [6]Vadlamudi NK, Saatchi A, Patrick DM, et al. Impact of the 13-valent pneumococcal conjugate vaccine on acute otitis media and acute sinusitis epidemiology in British Columbia, Canada J Antimicrob Chemother, 2021.PMID 34021757