Evidence map›Paper›PMID 42223618›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Incidence of mastoiditis complications in relation to prior community-based antibiotic treatment.

Nitzan Sofer, Ayalon Hadar, Gabriel Choucroun, Yehuda Tarnovsky, Ronen Perez, Pierre Attal, Chanan Shaul

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from 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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Nitzan Sofer *Department of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel.
Ayalon Hadar *Department of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel.
Gabriel ChoucrounDepartment of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel.
Yehuda TarnovskyDepartment of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel.
Ronen PerezDepartment of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel.
Pierre AttalDepartment of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel.
Chanan ShaulDepartment of Otolaryngology, Head and Neck Surgery, The Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University, POB 3235, Jerusalem, 91031, Israel. hananshaul@gmail.com.ORCID http://orcid.org/0000-0001-7064-0781

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the association between prior community-based antibiotic treatment for acute otitis media (AOM) and the incidence and severity of complications in children hospitalized with acute mastoiditis (AM), noting that this design does not address whether prior antibiotic treatment prevents AM development.

methodsThis retrospective cohort study analyzed medical records of 522 children (age < 15 years) diagnosed with AM at a tertiary medical center between 2015 and 2025. Children were categorized by prior antibiotic exposure: those receiving antibiotics for > 48 h before hospitalization versus those receiving < 48 h or none. The primary outcome was the presence of complicated AM, defined as extracranial (subperiosteal abscess) or intracranial (epidural abscess, sigmoid sinus thrombosis, brain abscess, or meningitis) complications.

resultsOf 522 children, 110 (21%) received prior antibiotics and 412 (79%) did not. While the composite complication rate was higher in the prior treatment group (54.5% vs. 38.6%, unadjusted OR = 1.91, p = 0.003), prior antibiotic treatment was not significantly associated with specific complication types, including subperiosteal abscess (adjusted OR = 0.67, p = 0.37) or intracranial complications (adjusted OR = 1.74, p = 0.13). Inflammatory markers, hospitalization length, imaging use, and surgical intervention rates were comparable between groups. Fusobacterium necrophorum in blood cultures was significantly associated with complications regardless of prior antibiotic exposure.

conclusionsAmong children hospitalized with AM, prior antibiotic treatment was not associated with increased rates of specific complications. The difference in composite outcomes likely reflects selection bias rather than a true treatment effect. Causal inference is limited by confounding by indication and unmeasured baseline severity differences.

Indexed as

Anti-Bacterial AgentsMastoiditisOtitis MediaAcute DiseaseAdolescentBrain AbscessChildChild, PreschoolEpidural AbscessFemaleHumansIncidenceInfantMaleRetrospective StudiesSinus Thrombosis, IntracranialAnti-Bacterial AgentsAcute mastoiditisAcute otitis mediaEpidural abscessSigmoid sinus thrombosisSubperiosteal abscess

Identifiers

PMID42223618
PMCPMC13615129

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