SynthesisThe Cochrane database of systematic reviews2004
Antibiotics for acute otitis media in children.
Synthesis in The Cochrane database of systematic reviews, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
67 citing papers in PubMed, 4 syntheses or guidelines pooled it, 170 citations in OpenAlex.
- Antibiotics for acute otitis media in children.The Cochrane database of systematic reviews · 2015Pooled it
- Korean clinical practice guidelines: otitis media in children.Journal of Korean medical science · 2012Guideline
- Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Pooled it
- Where is the supporting evidence for treating mild to moderate chronic obstructive pulmonary disease exacerbations with antibiotics? A systematic review.BMC medicine · 2008Pooled it
- Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial.BMJ (Clinical research ed.) · 2017Trial
- Public reporting improves antibiotic prescribing for upper respiratory tract infections in primary care: a matched-pair cluster-randomized trial in China.Health research policy and systems · 2014Trial
- Improving antibiotic prescribing in acute respiratory tract infections: cluster randomised trial from Norwegian general practice (prescription peer academic detailing (Rx-PAD) study).BMJ (Clinical research ed.) · 2013Trial
- Trial
- Effectiveness of multifaceted educational programme to reduce antibiotic dispensing in primary care: practice based randomised controlled trial.BMJ (Clinical research ed.) · 2012Trial
- Feasibility of a randomised trial of a continuing medical education program in shared decision-making on the use of antibiotics for acute respiratory infections in primary care: the DECISION+ pilot trial.Implementation science : IS · 2011Trial
- Effect of using an interactive booklet about childhood respiratory tract infections in primary care consultations on reconsulting and antibiotic prescribing: a cluster randomised controlled trial.BMJ (Clinical research ed.) · 2009Trial
- Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants.BMJ (Clinical research ed.) · 2009Trial
- Effectiveness of a multiple intervention to reduce antibiotic prescribing for respiratory tract symptoms in primary care: randomised controlled trial.BMJ (Clinical research ed.) · 2004Trial
- Nasopharyngeal rapid diagnostic testing to reduce unnecessary antibiotic use and individualize management of acute otitis media.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Improving Delayed Antibiotic Prescribing for Acute Otitis Media.Pediatrics · 2021Article
- Article
- Article
- Impact of different assumptions on estimates of childhood diseases obtained from health care data: A retrospective cohort study.Pharmacoepidemiology and drug safety · 2018Article
- Antibiotic prescribing for acute respiratory tract infections in Norwegian primary care out-of-hours service.Scandinavian journal of primary health care · 2017Article
- Antibiotics for acute respiratory tract infections: a mixed-methods study of patient experiences of non-medical prescriber management.BMJ open · 2017Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Updated by
- Update of
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute otitis media is one of the most common diseases in early infancy and childhood. Antibiotic use for acute otitis media varies from 31% in the Netherlands to 98% in the USA and Australia.
objectivesThe objective of this review was to assess the effects of antibiotics for children with acute otitis media. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE, Index Medicus (pre 1965), Current Contents and reference lists of articles from 1958 to January 2000. The search was updated in 2003. SELECTION CRITERIA: Randomised trials comparing antimicrobial drugs with placebo in children with acute otitis media. DATA COLLECTION AND ANALYSIS: Three reviewers independently assessed trial quality and extracted data. MAIN
resultsTen trials were eligible based on design, only eight of the trials, with a total of 2,287 children, included patient-relevant outcomes. The methodological quality of the included trials was generally high. All trials were from developed countries. The trials showed no reduction in pain at 24 hours, but a 30% relative reduction (95% confidence interval 19% to 40%) in pain at two to seven days. Since approximately 80% of patients will have settled spontaneously in this time, this means an absolute reduction of 7% or that about 15 children must be treated with antibiotics to prevent one child having some pain after two days. There was no effect of antibiotics on hearing problems of acute otitis media, as measured by subsequent tympanometry. However, audiometry was done in only two studies and incompletely reported. Nor did antibiotics influence other complications or recurrence. There were few serious complications seen in these trials: only one case of mastoiditis occurred in a penicillin treated group. REVIEWER'S
conclusionsAntibiotics provide a small benefit for acute otitis media in children. As most cases will resolve spontaneously, this benefit must be weighed against the possible adverse reactions. Antibiotic treatment may play an important role in reducing the risk of mastoiditis in populations where it is more common.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.