Trial reportBMJ (Clinical research ed.)2002
Predictors of poor outcome and benefits from antibiotics in children with acute otitis media: pragmatic randomised trial.
Trial report in BMJ (Clinical research ed.), 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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
20 citing papers in PubMed.
- Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial.BMJ (Clinical research ed.) · 2013Trial
- Trial
- Article
- Parental acceptability of the watchful waiting approach in pediatric acute otitis media.World journal of clinical pediatrics · 2016Article
- Have guidelines affected ear, nose, and throat specialists' diagnoses and the prescription of antibiotics for acute otitis media?Iranian journal of otorhinolaryngology · 2012Article
- Delayed antibiotic prescriptions for URTIs.Canadian family physician Medecin de famille canadien · 2011Article
- "Ten Commandments" for the Appropriate use of Antibiotics by the Practicing Physician in an Outpatient Setting.Frontiers in microbiology · 2011Article
- Ear discharge in children presenting with acute otitis media: observational study from UK general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Selective decrease in consultations and antibiotic prescribing for acute respiratory tract infections in UK primary care up to 2006.Journal of public health (Oxford, England) · 2009Article
- Acute otitis media in children: association with day care centers--antibacterial resistance, treatment, and prevention.Paediatric drugs · 2008Review
- Acute otitis media in children aged less than 2 years: drug treatment issues.Paediatric drugs · 2006Review
- Delayed prescribing of antibiotics for upper respiratory tract infection.BMJ (Clinical research ed.) · 2005Article
- Antibiotic treatment for acute otitis media: time to think again.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2005Article
- The use of infrared thermometry for the detection of fever.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- The inter-observer agreement of examining pre-school children with acute cough: a nested study.BMC family practice · 2004Article
- Pharmacological treatment of acute otitis media in children. A comparison among seven locations: Tenerife, Barcelona and Valencia (Spain), Toulouse (France), Smolensk (Russia), Bratislava (Slovakia) and Sofia (Bulgaria).European journal of clinical pharmacology · 2004Article
- Predicting complications from acute cough in pre-school children in primary care: a prospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- Delayed prescriptions in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2003Article
- Antibiotic Stewardship: An Important Pharmacy Role?The Canadian journal of hospital pharmacyArticle
- [Not Available].The Canadian journal of hospital pharmacyArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify which children with acute otitis media are at risk of poor outcome and to assess benefit from antibiotics in these children.
designSecondary analysis of randomised controlled trial cohort.
settingPrimary care.
participants315 children aged 6 months to 10 years.
interventionImmediate or delayed (taken after 72 hours if necessary) antibiotics.
main outcome measurePredictors of short term outcome: an episode of distress or night disturbance three days after child saw doctor.
resultsDistress by day three was more likely in children with high temperature (adjusted odds ratio 4.5, 95% confidence interval 2.3 to 9.0), vomiting (2.6,1.3 to 5.0), and cough (2.0, 1.1 to 3.8) on day one. Night disturbance by day three was more likely with high temperature 2.4 (1.2 to 4.8), vomiting (2.1,1.1 to 4.0), cough (2.3,1.3 to 4.2), and ear discharge (2.1, 1.2 to 3.9). Among the children with high temperature or vomiting, distress by day three was less likely with immediate antibiotics (32% for immediate v 53% for delayed, chi2=4.0; P=0.045, number needed to treat 5) as was night disturbance (26% v 59%, chi2=9.3; P=0.002; number needed to treat 3). In children without higher temperature or vomiting, immediate antibiotics made little difference to distress by day three (15% v 19%, chi2=0.74; P=0.39) or night disturbance (20% v 27%, chi2=1.6; P=0.20). Addition of cough did not significantly improve prediction of benefit.
conclusionIn children with otitis media but without fever and vomiting antibiotic treatment has little benefit and a poor outcome is unlikely.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.