Cost effectiveness in the choice of antibiotics for the initial treatment of otitis media in children: a decision analysis approach

Pediatr Infect Dis J. 1988 Jan;7(1):23-6. doi: 10.1097/00006454-198801000-00006.


If the initial use of amoxicillin fails to cure otitis media, a family will be burdened with medical costs for a second medication, additional office visit fees and time lost from employment. For some families the initial choice of a more expensive but more effective antibiotic may be more cost effective. Using a decision analysis approach we compared the cost effectiveness of amoxicillin and cefaclor. As the amoxicillin efficacy rate decreases or as parental salaries are increased, the cost-effective advantage moves towards cefaclor. With the decision analysis method described, a practitioner can use costs and efficacy rates relevant to his or her practice to determine the most cost-effective initial antibiotic for a child with otitis media.

MeSH terms

  • Amoxicillin / therapeutic use*
  • Cefaclor / therapeutic use*
  • Cephalexin / analogs & derivatives*
  • Child
  • Cost-Benefit Analysis
  • Decision Making
  • Drug Resistance, Microbial
  • Humans
  • Income
  • Otitis Media / drug therapy
  • Otitis Media / economics*


  • Cefaclor
  • Amoxicillin
  • Cephalexin