Watchful waiting is a cost-effective way of managing acute otitis media (AOM) suggests a recent retrospective analysis of 250 patients with the infection who were seen in emergency rooms. To reach that conclusion, investigators added their data to a decision analytic cost utility model that compared the American Academy of Pediatrics’ policy on watchful waiting to current practice. They found:

• 247 patients had AOM upon physical examination.
• 93.5% had been given antibiotics, 2.8% were watched, and 3.6% were given an antibiotic and sent home.
• Had the AAP policy been applied, 104 patients (42.1%) would have met the criteria for immediate antibiotics and 143 patients (57.9%) would have qualified for watchful waiting.
• Projecting these findings to a population of 1,000 patients with AOM, researchers concluded that watchful waiting would have saved $5,573 and resulted in 514 fewer immediate prescriptions for antibiotics.