Tiny Tim remembered.
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Biomedical subjects
Publications and source records attributed to C W Callahan.
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The United States Army is committed to providing quality health care for active-duty service members, their dependents, and retired service members. Historically, the Army has never had enough active-duty physicians to provide care for all its beneficiaries. Alternatives utilizing civilian health care providers have been established to provide the balance of the medical services. In this review, the cost of each of the civilian health care providers in the Ft. Hood, Texas area is compared to that of the Army pediatrician. The Army pediatrician proves to be the least expensive of the health care providers.
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Amoxicillin continues to be the drug of first choice in the treatment of acute otitis media in children, because it is generally considered to be the safest and least expensive of the available choices. However, amoxicillin may not be the most cost-effective therapy in some settings because of its decreasing efficacy and moderately high rate of minor adverse effects. In this review, the cost effectiveness of antibiotics used to treat otitis media in a large military pediatric clinic are compared, using the decision analysis method. With this model, trimethoprim-sulfamethoxyazole is more cost-effective than amoxicillin, and cefaclor, given twice a day for 5 days, is the next most cost-effective regimen. In addition, the major and minor adverse effects of each of the agents are compared and the additional impact on cost effectiveness is considered.
Otitis media can be a vexing, recurrent problem. An episode is often treated with antibiotics, followed by reevaluation at two weeks. The complete resolution of effusion, however, may never be documented. Impairments in children's speech, language and cognition have been related to chronic and continuous middle ear disease. Responses to antibiotic regimens must be carefully monitored. Follow-up is essential.
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