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Archives of Disease in Childhood - Education and Practice 2007;92:ep159
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health
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EVIDENCE-BASED MEDICINE

Review: children <2 years of age with bilateral acute otitis media and children with otorrhoea benefit most from antibiotics

Rovers MM, Glasziou P, Appelman CL, et al. Antibiotics for acute otitis media: a meta-analysis with individual patient data. Lancet 2006;368:1429–35.[CrossRef][Medline]

Q In children with acute otitis media (AOM), which subgroups of children benefit from treatment with antibiotics?

Clinical impact ratings GP/FP/Primary care ******{star} Infectious disease ******{star} Surgery—ear nose throat ******{star} Paediatrics *****{star}{star}

Keywords: anti-bacterial agents; otitis media

The first 150 words of the full text of this article appear below.


METHODS

Formula

Data sources: Cochrane Library, PubMed, EMBASE/Excerpta Medica, and proceedings of international symposia.


Formula

Study selection and assessment: randomised controlled trials (RCTs) that compared antibiotics with placebo or no treatment in children 0–12 years of age with AOM and assessed pain and fever. 6 RCTs (n = 1643, mean age 3.4 y [range 0–11], 50% boys) met the selection criteria, and the authors were willing to supply raw data. In a quality assessment based on 4 criteria (randomisation procedure; allocation concealment; follow up; and blinding of patients, caregivers, and outcome assessors), the methodological quality was generally high.


Formula

Outcomes: a composite outcome of an extended course of AOM consisting of pain (yes or no on parent diary), fever (temperature >=38° C), or both at 3–7 days. Secondary outcomes were pain and fever assessed separately, and adverse effects.


MAIN RESULTS
Overall, antibiotics reduced an extended course of AOM, pain, or fever (table). Subgroups of children <2 . . . [Full text of this article]

Ian Williamson, MD

University of Southampton Southampton, UK






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