TOPLINE:

Amoxicillin was prescribed in more than 80% of children with acute otitis media (AOM) at two Finnish hospitals, and a 5-day course was most common, suggesting high adherence to national guidelines for this condition.

METHODOLOGY:

• This retrospective register-based cohort study at two Finnish hospitals (Turku and Vaasa) examined the antibiotic choice and treatment duration for children diagnosed with AOM during 2023.
• The study included 1240 children from Turku (median age, 2.0 years; 55.7% boys) and 393 children from Vaasa (median age, 3.0 years; 54.2% boys); those with a previous diagnosis of AOM, tympanostomy tubes, or bacterial co-diagnoses that would affect the antibiotic choice were excluded.
• The primary outcome was the prescription rate of amoxicillin, amoxicillin-clavulanate, or other antibiotics among children with AOM.

TAKEAWAY:

• Amoxicillin was prescribed to 80.9% of children in Turku and 80.7% of those in Vaasa, and amoxicillin-clavulanate was the second most common choice (10.1% and 8.7%, respectively).
• A 5-day antibiotic course was most common (52.4% in Turku and 37.7% in Vaasa), followed by 7-day courses (18.1% in Turku and 31.3% in Vaasa).
• Treatment failure, defined as a change in antibiotic treatment within 1 week, was uncommon, suggesting that the initial management was usually effective.

IN PRACTICE:

"Our results show that most cases of AOM were treated with a 5-day amoxicillin regimen, followed by amoxicillin-clavulanate as the second most frequently prescribed antimicrobial treatment. This indicates that compliance with the Finnish guidelines for AOM is good in the two Finnish hospitals studied," the authors wrote.

SOURCE:

This study was led by Lisa Kulppi, Vaasa Central Hospital, Wellbeing Services County of Ostrobothnia, Vaasa, Finland. It was published online on April 27, 2026, in the European Journal of Pediatrics.

LIMITATIONS:

Data were collected retrospectively, and some records were incomplete. The diagnosis of AOM relied on clinical assessments and otoscopy, which are subjective. The researchers could not confirm whether patients filled delayed prescriptions or sought care at other facilities after the index visit.

DISCLOSURES:

This study was funded by the Vaasa Medical Association, the Jussi Lalli and Eeva Mariapori-Lalli Foundation, the Swedish-speaking Medical Society of Finland, the Rauno and Anne Puolimatka Foundation, and the State Research Funding of the Wellbeing Services County of Ostrobothnia. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.