TOPLINE

Rates of otitis media consultations and consultations with antibiotic prescribing in children, which dropped during the onset of the COVID pandemic, recovered post-pandemic in the UK and Netherlands by 2024.

METHODOLOGY

• Researchers conducted a retrospective population-based cohort study using routine electronic health records from general practice in the UK and Netherlands spanning from January 2009 to September 2024.
• Focusing on children aged 0-18 years, the study analysed 3,529,255 otitis media episodes in the UK and 134,408 otitis media episodes in Netherlands.
• An otitis media episode was noted when at least a 28-day gap without any related consultation was present, and data on oral and topical antibiotic prescriptions within 2 days before or after the episode were collected.
• The study period was divided into a pre-pandemic period (January 2009 to February 2020) and a combined pandemic and post-pandemic period (March 2020 to September 2024), with March 2020 used as the breakpoint to reflect the onset of the pandemic.
• The primary outcome was the rate of monthly otitis media consultation over time; secondary outcomes were the proportion and rate of the consultations with oral or topical antibiotic prescriptions.

TAKEAWAY

• In the UK, the otitis media consultation rate declined from 10.5 per 1000 person-months in January 2009 to 4.8 per 1000 person-months in February 2020, then fell sharply to 1.6 per 1000 person-months when the pandemic started (P < .001) and increased to 4.6 per 1000 person-months by September 2024.
• In Netherlands, the otitis media consultation rate remained stable at 11.2 and 11.9 per 1000 person-months in January 2009 and February 2020, respectively, dropped significantly to 6.0 per 1000 person-months at the onset of the pandemic (P < .001), and then returned to 11.6 per 1000 person-months by September 2024.
• The proportion of otitis media consultations with oral antibiotic prescriptions in the UK stayed around 74% from January 2009 to February 2020, dropped to 72.1% at the onset of the pandemic, and then rose again to 76.0% by September 2024. In Netherlands, consultations with oral antibiotic prescriptions fell from 39.4% in January 2009 to 30.6% in February 2020, dropped further to 26.8% at the onset of the pandemic, and returned to 30.6% by September 2024.
• From January 2009 to February 2020, prescription rates for topical antibiotics increased before the pandemic from 7.6% to 11.0% in the UK and from 12.1% to 18.8% in Netherlands. At the onset of the pandemic, topical antibiotic prescribing in the UK rose significantly to 15.8% before falling to 12.2% by September 2024; however, in Netherlands, the proportion was relatively stable at 18.6% by September 2024.

IN PRACTICE

"OM [otitis media] continues to pose a major burden on both healthcare systems and families, highlighting the need for ongoing efforts to understand and reduce this burden," the authors of the study wrote.

SOURCE

The study was led by Joline L.H. de Sévaux, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands. It was published online on July 29, 2026, in BJGP Open.

LIMITATIONS

The study used diagnosis codes from everyday clinical practice, so some cases may have been misclassified. The observational study design precluded the determination of cause-and-effect relationships. Primary care databases also did not have dependable information on complications of otitis media, such as mastoiditis, or respiratory pathogens causing the infection, thereby affecting the assessment of trends in these outcomes.

DISCLOSURES

The study was supported by a grant from the Netherlands Organisation for Health Research and Development. The authors declared having no conflicts of interest.

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