Multivariate-Adjusted Predictors of Assigning a Bacterial Diagnosis and of Prescribing an Antibiotic

Predictor VariableChange in Probability of Assigning a Bacterial Diagnosis95% CIChange in Probability of Prescribing Antibiotics95% CI
Child sick for <2 days10.3%*5.1%, 15.5%8.4%*2.2%, 14.6%
Presence of fever both at home and in the physician's office6.1%*1.4%, 10.8%11.3%*4.1%, 14.4%
Abnormal appearance of the tympanic membrane74.1%*64.7%, 83.5%55.0%*47.2%, 62.8%
Presence of purulent rhinorrhea on examination27.3%*14.1%, 40.5%30.5%*15.6%, 45.4%
Pharyngeal erythema found in a child who presented with sore throat16.8%*9.6%, 24.0%13.4%*2.7%, 24.1%
Presence of rhonchi or wheezing on examination−5.1%−11.4%, 1.2%12.6%*3.3%, 21.9%
Parent expects to receive antibiotics for child4.6%−1.9%, 11.1%5.0%−1.7%, 11.7%
Physician perceives that parent expects to receive antibiotics for child7.4%*0.6%, 14.2%21.5%*13.0%, 30.0%
Parent is Latino−7.6%*−14.9%, −0.3%−4.4%−11.0%, 2.2%
Parent is African American−13.1%*−22.1%, −4.1%−3.0%−10.2%, 4.2%
Parent is Asian13.1%*3.1%, 23.1%8.3%0.0%, 16.6%
  • * P < .05 for increase or decrease in probability of the outcome.

  • Abnormal appearance of the tympanic membrane was defined as the physician indicating on the postvisit survey that at least 1 tympanic membrane had at least 1 of the following characteristics: bulging, perforated, retracted, purulent effusion, serous effusion, opaque/dull, or red or yellow in color. Findings consistent with otitis media with effusion, eg, serous effusion, retracted, were included because 71% of otitis media with effusion cases received antibiotics.

  • Relative to non-Hispanic white parents.