Article: Antibiotics for otitis media with effusion in children: A Cochrane Systematic Review
Take home points
- Systematic review on the effectiveness of oral antibiotics in children with otitis media effusion (OME)
- Children treated with oral antibiotics are more likely to have complete resolution at two to three months (moderate quality evidence)
- Children treated with oral antibiotics are also more likely to experience diarrhea, vomiting or skin rash (low quality evidence)
- No association with fewer ventilation tube insertions, Impact on short term hearing is uncertain, no data on speech, language, and cognitive development.
- Results of the review do not support routine use of antibiotics for OME
The Details:
- Systematic review
- Includes randomized controlled trials (RTC)- 23 trials, 3258 children
- Children aged 18 or under with dx of unilateral or bilateral OME
- Excluded- children with tubes present, chronic suppurative otitis media, known immunodeficiency, down syndrome, or craniofacial anomalies
- Intervention- oral antibiotics of any kind
- Primary outcomes
- Complete resolution of OME at two-three months post randomization, adverse effects- diarrhea, vomiting, skin rash
- Secondary outcomes
- Complete resolution of OME at various points, hearing, language and speech, cognitive development, QOL, insertion of ventilation tubes, TM sequelae, AOM episodes
- Results
- 61% of studies, 14/23 treated for 10 to 14 days
- 61% included children under 2 years old
- Figure 4: Oral antibiotics more likely to have complete resolution of OME at 2-3 months post randomization
- RR 2.00, 95% CI 1.58 to 2.53, Number needed to treat to benefit = 5
- Figure 5: Adverse Effects including diarrhea, vomiting and skin rash
- RR 2.15, 95% CI 1.29 to 3.60, Number needed to treat to harm = 20
Summary contributed by Sahil Patel