Acute otitis media in children

Overview

Abstract | Cite as | Substantive changes

Abstract

INTRODUCTION: Acute otitis media (AOM) is a common reason for primary care visits in children. Yet, there is considerable debate on the most effective treatment. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments (analgesics, antibiotics, and myringotomy) in children with AOM? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 17 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics, delayed antibiotics, immediate antibiotics, longer courses of antibiotics, and myringotomy.

Cite as

Venekamp RP, Damoiseaux RA and Schilder AG. Acute otitis media in children. Clinical Evidence 2014; 09:.

Top

Substantive changes

Analgesics (paracetamol, NSAIDs, topical anaesthetic ear drops) One systematic review updated.[12] Categorisation unchanged (likely to be beneficial).

Antibiotics versus placebo Evidence re-evaluated. One systematic review updated.[10] Categorisation unchanged (trade-off between benefits and harms).

Type of antimicrobial agent (antibiotic regimen) Title of option changed from 'Choice of antibiotic regimen' to 'Type of antimicrobial agent (antibiotic regimen)'. One systematic review updated,[21] one RCT added.[22] Categorisation unchanged (trade-off between benefits and harms).

Immediate versus delayed antibiotic treatment One systematic review updated.[23] Categorisation unchanged (trade-off between benefits and harms).

Latest citations

Management of acute otitis media: update. ( 22 September 2014 )

Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. ( 22 September 2014 )