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January 10, 2007

Wait-and-See Prescription for Acute Otitis Media—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(2):152-153. doi:10.1001/jama.297.2.152-c

In Reply: Dr Johnson questions whether some patients with high fever and severe otalgia for longer than 72 hours, as discussed by Dr Little in his editorial, were included in our study. Neither severity of symptoms nor duration were exclusion criteria. Prior studies evaluating the optional antibiotic prescription model have excluded children based on height of fever,1,2 but we chose not to do so. In our study, 8% of patients in the WASP group had a documented temperature of 39.0°C or higher. Of these, 27% did not have their prescriptions filled by the parent, compared with 62% of all patients assigned to the WASP group. Of all children enrolled in the study with a temperature of 39.0°C or higher, no parent reported an unscheduled visit to a clinician at the 11- to 14-day follow-up; therefore it seems likely that all children who presented with high fever did well.

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