Trial reportBMJ (Clinical research ed.)2001
Pragmatic randomised controlled trial of two prescribing strategies for childhood acute otitis media.
Trial report in BMJ (Clinical research ed.), 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers, 16 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
118 citing papers in PubMed, 16 syntheses or guidelines pooled it.
- Pooled it
- Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Pooled it
- A systematic review of national interventions and policies to optimize antibiotic use in healthcare settings in England.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Antibiotic treatment to prevent pediatric acute otitis media infectious complications: A meta-analysis.PloS one · 2024Pooled it
- Antibiotics for acute otitis media in children.The Cochrane database of systematic reviews · 2023Pooled it
- Immediate versus delayed versus no antibiotics for respiratory infections.The Cochrane database of systematic reviews · 2023Pooled it
- Pooled it
- Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- Systematic review of patient-oriented interventions to reduce unnecessary use of antibiotics for upper respiratory tract infections.Systematic reviews · 2020Pooled it
- Delayed antibiotic prescriptions for respiratory infections.The Cochrane database of systematic reviews · 2017Pooled it
- Antibiotics for acute otitis media in children.The Cochrane database of systematic reviews · 2015Pooled it
- Chinese proprietary herbal medicine listed in 'China national essential drug list' for common cold: a systematic literature review.PloS one · 2014Pooled it
- Pooled it
- Pooled it
- Otitis media in children (acute).BMJ clinical evidence · 2007Pooled it
- Interventions to improve antibiotic prescribing practices in ambulatory care.The Cochrane database of systematic reviews · 2005Pooled it
- Nasal sprays and a behavioural intervention for respiratory tract infections in primary care: 12-month follow-up of a randomised open-label trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Trial
- Topical or oral antibiotics in childhood acute otitis media and ear discharge: a randomized controlled non-inferiority trial.Family practice · 2024Trial
- Cost of childhood acute otitis media in primary care in the Netherlands: economic analysis alongside a cluster randomised controlled trial.BMC health services research · 2021Trial
- Improving pain management in childhood acute otitis media in general practice: a cluster randomised controlled trial of a GP-targeted educational intervention.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Trial
58 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare immediate with delayed prescribing of antibiotics for acute otitis media.
designOpen randomised controlled trial.
settingGeneral practices in south west England.
participants315 children aged between 6 months and 10 years presenting with acute otitis media.
interventionsTwo treatment strategies, supported by standardised advice sheets-immediate antibiotics or delayed antibiotics (antibiotic prescription to be collected at parents' discretion after 72 hours if child still not improving).
main outcome measuresSymptom resolution, absence from school or nursery, paracetamol consumption.
resultsOn average, symptoms resolved after 3 days. Children prescribed antibiotics immediately had shorter illness (-1.1 days (95% confidence interval -0.54 to -1.48)), fewer nights disturbed (-0.72 (-0.30 to -1.13)), and slightly less paracetamol consumption (-0.52 spoons/day (-0.26 to -0.79)). There was no difference in school absence or pain or distress scores since benefits of antibiotics occurred mainly after the first 24 hours-when distress was less severe. Parents of 36/150 of the children given delayed prescriptions used antibiotics, and 77% were very satisfied. Fewer children in the delayed group had diarrhoea (14/150 (9%) v 25/135 (19%), chi(2)=5.2, P=0.02). Fewer parents in the delayed group believed in the effectiveness of antibiotics and in the need to see the doctor with future episodes.
conclusionImmediate antibiotic prescription provided symptomatic benefit mainly after first 24 hours, when symptoms were already resolving. For children who are not very unwell systemically, a wait and see approach seems feasible and acceptable to parents and should substantially reduce the use of antibiotics for acute otitis media.
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