COVID-19 impact on otitis media consultations and antibiotic use in general practice.

Abstract

Consultations for childhood otitis media (OM) declined during the COVID-19 pandemic, but how GP consultation and antibiotic prescribing rates evolved since is unknown. To examine trends in OM consultations and antibiotic prescribing before, during, and after the COVID-19 pandemic in the UK and the Netherlands. Population-based cohort study using routine electronic health records from general practice in the UK and the Netherlands (2009-2024). Children aged 0-18 years were included, and OM-related consultations and antibiotic prescriptions were extracted. The study period was divided into pre-pandemic (2009-February 2020) and pandemic/post-pandemic (March 2020-2024) periods. Interrupted time series analyses were conducted, adjusting for seasonality and autocorrelation. In total, 3 529 255 OM episodes in the UK and 134 408 in the Netherlands were analysed. In the UK, OM consultation rates declined from 10.5 in 2009 to 4.8 per 1000 person-months in February 2020; In the Netherlands, rates were 11.2 and 11.9, respectively. At the pandemic's onset, rates dropped sharply (<i>P</i><0.001), then gradually increased to 4.6 (UK) and 11.6 (Netherlands) per 1000 person-months in 2024. From 2009 to March 2020, oral antibiotics were prescribed in~74% of UK consultations and declined from 39.4% to 30.6% in the Netherlands. After declining to 72.1% (UK) and 26.8% (Netherlands) at the pandemic's onset, proportions returned to pre-pandemic levels by 2024. OM remains a major burden in general practice, with consultation and antibiotic prescribing rates returning to pre-pandemic levels. Persistent between-country differences highlight the need to better understand healthcare-seeking behaviour and prescribing practices.