Acute otitis media (AOM), a common childhood ear infection, is at the center of a growing debate over health disparities in pediatric care. Recent studies have shed light on troubling differences in antibiotic prescribing patterns based on race and socioeconomic factors, potentially impacting millions of children annually.
The American Academy of Pediatrics recommends either observation or antibiotic therapy for AOM, depending on the severity and age of the child. High-dose amoxicillin is the first-line treatment for severe cases in children over six months old. However, research indicates that these guidelines are not being applied equally across all patient populations.
A retrospective cohort study revealed that Black children were less likely to receive antibiotic prescriptions for acute visits compared to non-Black children, even when seen by the same clinician. This disparity persisted after adjusting for factors such as age, gender, and insurance status. Additionally, Black children were less frequently diagnosed with AOM than their non-Black counterparts.
Socioeconomic factors also play a role in treatment disparities. A cross-sectional study found that children from areas with lower social deprivation index scores had reduced odds of receiving treatment for recurrent otitis media. This index considers factors like poverty, education levels, and housing conditions.
These inequities in antibiotic prescribing can have serious consequences. Overprescribing contributes to antibiotic resistance and adverse events, while undertreatment can lead to complications such as hearing loss or more severe infections.
Pharmacists are increasingly recognized as crucial players in addressing these disparities. Their role in antimicrobial stewardship programs helps reduce unnecessary antibiotic use and optimize therapy. By being aware of these disparities, pharmacists can contribute to more equitable healthcare practices and improved outcomes for all children with AOM.
As the healthcare community grapples with these findings, there is a growing call for more targeted interventions and education to ensure that all children, regardless of race or socioeconomic status, receive appropriate and timely treatment for ear infections.
See: “Antibiotic Management and Health Disparities in Acute Otitis Media: Implications for Pediatric Care and Pharmacy Practice” (January 7, 2025)
