Otitis media in children (acute).
BACKGROUND
In the UK, about 30% of children under 3 years of age visit their GPs each year with acute otitis media (AOM), and 97% of these receive antibiotics. In the USA, AOM is the most common reason for outpatient antibiotic treatment. Without antibiotics, AOM resolves within 24 hours in about 60% of children, and within 3 days in about 80% of children.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for AOM in children; and what are the effects of interventions to prevent recurrence? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2007. (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics, delayed antibiotics, immediate antibiotics, long-term antibiotic prophylaxis, longer courses of antibiotics, myringotomy, pneumococcal vaccination, tympanostomy with ventilation tubes.
O'Neill
Paddy
P
Norton Medical Centre, Stockton on Tees, UK.
Roberts
Tony
T
Bradley Stevenson
Clare
C
D000208:Acute Disease; D000700:Analgesics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D010033:Otitis Media / Q000188:drug therapy; D012008:Recurrence
D000700:Analgesics; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal