Quality use of medicines: The child with acute otitis media

Abstract

Infectious diseases pose quite different challenges to those who seek to apply evidence-based guidelines, as they do to managers of Essential Medicines programmes. The first challenge is that of resistance - unlike the causes of non- infectious conditions, microbes can develop resistance to antimicrobials over time. This may render yesterday's guidelines, based on yesterday's resistance patterns, quite useless today. The second challenge is that of location, the prevalence of causative organisms may vary from site to site (as can resistance), but in addition, factors other than the microbe involved may alter outcomes and hence demand differences in treatment. This review will use acute otitis media (AOM) in children as an example of such a condition, in order to explore these challenges more closely.