Acute otitis media, antimicrobial resistant Streptococcus pneumoniae, and prescribing practices of nurse practitioners, physicians, and physician assistants in Alask

Antimicrobial resistant Streptococcus pneumoniae increases morbidity and mortality in human populations. The Centers for Disease Control and Prevention (CDC) initially chose acute otitis media (AOM) for developing antimicrobial prescribing guidelines, in an attempt to lessen the further development and spread of antimicrobial resistant S. pneumoniae. This study used a survey to examine antimicrobial prescribing methods of clinicians in Alaska for AOM in children 2 months to 5 years of age and compared them to the CDC guidelines. The findings revealed low adherence to portions of the CDC guidelines and significant differences in prescribing practices among clinicians. The study further revealed clinicians prescribed a significant amount of trimethoprim/sulfamethoxazole and azithromycin for AOM. Evaluation and diagnostic criteria for AOM essentially followed recommended criteria. Recommendations include providing education regarding implementation of the CDC guidelines if the goal is to improve treatment of AOM and prevent the further development of antimicrobial resistant S. pneumoniae.