Concern about reducing the risk of serious complications can drive antibiotic prescribing for common infections, such as acute otitis media (AOM) and acute sinusitis (AS), and use of antibiotics is the major driver of antibiotic resistance. The association between use of antibiotics for AOM and AS, and the subsequent risk of acute mastoiditis, brain abscess, and orbital cellulitis, has not been adequately explored. This study demonstrates that these serious complications are extremely uncommon. Antibiotic use was associated with a lower risk of acute mastoiditis following AOM and brain abscess following AS, but for both conditions thousands of patients would need to be treated to prevent a single instance of one complication. |