AOM Guideline Failed to Rein In Prescribing

For example, data on the increase in the use of azithromycin are problematic as it is a drug with a long half-life and is believed to promote the emergence of resistance to a greater extent than some other antibiotics. Even so, studies have shown that pediatricians choose azithromycin twice as often in children with recurrent AOM, which is backward, as it would be less likely to be effective in a recurrent episode than in a first. I think this confirms that selection of antibiotics is based more on convenience, taste, and possibly marketing than on an understanding of the activity and limitations of the antibiotic.

STEPHEN I. PELTON, M.D,. is director of pediatric infectious diseases at Boston Medical Center. He is a consultant for GlaxoSmithKline, Novartis, and Wyeth and is on the speakers bureau for MedImmune Inc. and Sanofi Pasteur Inc.

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