Cost effectiveness of antibiotic therapy for otitis media in a military pediatric clinic

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Abstract
Amoxicillin continues to be the drug of first choice in the treatment of acute otitis media in children, because it is generally considered to be the safest and least expensive of the available choices. However, amoxicillin may not be the most cost-effective therapy in some settings because of its decreasing efficacy and moderately high rate of minor adverse effects. In this review, the cost effectiveness of antibiotics used to treat otitis media in a large military pediatric clinic are compared, using the decision analysis method. With this model, trimethoprim-sulfamethoxyazole is more cost-effective than amoxicillin, and cefaclor, given twice a day for 5 days, is the next most cost-effective regimen. In addition, the major and minor adverse effects of each of the agents are compared and the additional impact on cost effectiveness is considered.