Medicines adherence may be a problem for some people with medicines that require frequent dosing (for example, some antibiotics) or longer treatment duration (see the NICE guideline on medicines adherence).
Respiratory tract infections, including acute otitis media, are a common reason for consultations in primary care, and therefore are a common reason for potential antibiotic prescribing.
There is potential for resource savings if no antibiotic or a back-up antibiotic prescription is used. There was significantly lower antibiotic use with back‑up antibiotics compared with immediate antibiotics, both when the back‑up antibiotic prescription was given at the time of consultation (38% compared with 87%; moderate quality evidence) and when the prescription had to be collected on a separate visit (24% compared with 87%; high quality evidence). There was no significant difference between groups in re‑consultation rates (low quality evidence). This was based on a systematic review of RCTs (Spurling et al. 2013).
Recommended antibiotics are all available as generic formulations, see the Drug Tariff for costs.