Aggregate evidence quality . | Grade B . |
---|---|
Benefits | Initial antibiotic treatment: Slightly increased likelihood of more rapid resolution of symptoms; slightly increased likelihood of resolution of AOM. Initial observation: Decreased use of antibiotics; decreased adverse effects of antibiotics; decreased potential for development of bacterial resistance. |
Risks, harms, cost | Initial antibiotic treatment: Adverse events attributable to antibiotics such as diarrhea, rashes, and allergic reactions. Overuse of antibiotics leads to increased bacterial resistance. Initial observation: Possibility of needing to start antibiotics in 48 to 72 h if the patient continues to have symptoms. Minimal risk of adverse consequences of delayed antibiotic treatment. Potential increased phone calls and doctor visits. |
Benefits-harms assessment | Slight degree of benefit of initial antibiotics over harm. |
Value judgments | Observation is an option as the benefits and harms approach balance. |
Role of patient preference | Joint decision-making with the family is essential before choosing observation. |
Intentional vagueness | Joint decision-making is highly variable from family to family. |
Exclusions | None |
Strength | Recommendation. |
Aggregate evidence quality . | Grade B . |
---|---|
Benefits | Initial antibiotic treatment: Slightly increased likelihood of more rapid resolution of symptoms; slightly increased likelihood of resolution of AOM. Initial observation: Decreased use of antibiotics; decreased adverse effects of antibiotics; decreased potential for development of bacterial resistance. |
Risks, harms, cost | Initial antibiotic treatment: Adverse events attributable to antibiotics such as diarrhea, rashes, and allergic reactions. Overuse of antibiotics leads to increased bacterial resistance. Initial observation: Possibility of needing to start antibiotics in 48 to 72 h if the patient continues to have symptoms. Minimal risk of adverse consequences of delayed antibiotic treatment. Potential increased phone calls and doctor visits. |
Benefits-harms assessment | Slight degree of benefit of initial antibiotics over harm. |
Value judgments | Observation is an option as the benefits and harms approach balance. |
Role of patient preference | Joint decision-making with the family is essential before choosing observation. |
Intentional vagueness | Joint decision-making is highly variable from family to family. |
Exclusions | None |
Strength | Recommendation. |