Baseline characteristics
| Characteristics | Intervention (N = 48; 19 practices) | Usual care (N= 44; 18 practices) |
|---|---|---|
| GP practices | ||
| Geographical location, n (%) | ||
| Urban | 10 (52.6) | 8 (44.4) |
| Semi-rural | 4 (21.1) | 6 (33.3) |
| Rural | 5 (26.3) | 4 (22.2) |
| Practice population, mean ± SD | 4068 ± 2275 | 4402 ± 2850 |
| Percentage young children, mean ± SD | 10.9 ± 2.4 | 11.5 ± 3.1 |
| GPs | ||
| Sex, male, n (%) | 27 (56.3) | 22 (50.0) |
| Age, years, mean ± SD | 50 ± 11 | 47 ± 11 |
| Experience, years, mean ± SD | 19 ± 11 | 17 ± 11 |
| Intervention | Usual care | |
| (N = 94; 19 practices) | (N= 129; 18 practices) | |
| Children | ||
| Age, months, median (IQR) | 38 (13–62) | 43 (20–66) |
| Sex, male, n (%) | 54 (57.4) | 66 (51.2) |
| Weight, kg, median (IQR)a | 15.0 (10.0–20.0) | 14.4 (9.8–18.9) |
| Daycare or school attendance, n (%)a | 38 (46.9) | 48 (37.2) |
| Parental educational level (higher), n (%)a | ||
| Mother | 44 (55.7) | 55 (53.4) |
| Father | 33 (48.5) | 52 (54.7) |
| Medical history, n (%) | ||
| Recurrent AOM | 14 (14.9) | 12 (9.3) |
| Recurrent URTI | 13 (13.8) | 11 (8.5) |
| Previous ENT surgery | 15 (16.0) | 8 (6.2) |
| Atopic constitution | 16 (17.0) | 8 (6.2) |
| Risk factors, n (%)a | ||
| Pneumococcal vaccination | 79 (97.5) | 106 (97.2) |
| Household smoking | 4 (4.9) | 4 (3.7) |
| Symptoms prior to consultation (parent-reported) | ||
| Ear pain, n (%)a | 75 (90.4) | 91 (84.3) |
| Days, n, median (IQR) | 2 (0.5–3.5) | 3 (1–5) |
| Otorrhea, n (%)a | 12 (15.4) | 16 (16.0) |
| Days, n, median (IQR) | 2 (0–5) | 2 (0–4.5) |
| Fever, n (%)a | 50 (60.2) | 76 (67.3) |
| Days, n, median (IQR) | 2 (1–3) | 3 (2–4) |
| Physical examination, n (%) | ||
| Temperature, °C, mean ± SDa | 37.6 ± 0.9 | 37.9 ± 1.1 |
| Ill appearance | 18 (19.6) | 25 (20.3) |
| Unilateral AOM | 65 (69.1) | 79 (61.2) |
| Redness | 60 (92.3) | 72 (91.1) |
| Bulging | 29 (44.6) | 52 (65.8) |
| Otorrhea | 4 (6.2) | 8 (10.1) |
| Bilateral AOM | 29 (30.9) | 50 (38.8) |
| Redness | 29 (100) | 45 (90.0) |
| Bulging | 17 (58.6) | 36 (72.0) |
| Otorrhea | 3 (10.3) | 5 (10.0) |
| Symptoms at baseline (parent-reported), n (%)a | ||
| Proportion of children with ear pain | 87 (98.9)b | 117 (97.5) |
| Proportion of children with fever | 40 (48.2) | 67 (59.8) |
| Oral antibiotics, immediate prescriptions, n (%) | 22 (23.4) | 48 (37.2) |
| Amoxicillin | 17 (77.3) | 45 (93.8) |
| Amoxicillin/clavulanic acid | 1 (4.5) | 3 (6.3) |
| Azitromycin | 3 (13.5) | 0 (0.0) |
| Cotrimoxazole | 1 (4.5) | 0 (0.0) |
Values given as n (%) unless stated otherwise. Details on other baseline symptoms are presented in Supplementary Table S1.
↵a Missing data for both intervention (I) and usual care (UC) groups: weight (I, n = 19; UC, n = 31), daycare attendance (I, n = 13; UC, n = 21), education father (I, n = 26; UC, n = 34), education mother (I, n = 15; UC, n = 26), vaccination (I, n = 13; UC, n = 20), household smoking (I, n = 13; UC, n = 21), otorrhea prior to consultation (I, n = 16; UC, n = 29), ear pain prior to consultation (I, n = 11; UC, n = 21), fever prior to consultation (I, n = 11; UC, n = 16), temperature (I, n = 4; UC, n = 6), ill appearance (I, n = 2; UC, n = 6), ear pain at baseline (I, n = 6; UC, n = 9), fever at baseline (I, n = 11; UC, n = 17).
↵b Ear pain as reported by parents, GPs reported ear pain in all subjects. °C = degrees Celsius. AOM = acute otitis media. ENT = ear, nose, and throat. URTI = upper respiratory tract infection.