title: [Acute otitis media: do not change the Dutch practice guideline].
abstract: Two recent clinical trials have again shown that antibiotics are effective in the management of young children with acute otitis media (AOM). Should this change our reserved attitude towards the use of antibiotics? According to the rules for evidence-based medicine, we cannot ignore the vast body of evidence already existing unless new trials are methodologically better and their results differ from previous trials. This does not seem to be the case. The patient characteristics of these trials are similar to those of a previously published individual patient data meta-analysis. The primary outcome 'symptom scores' reported by Hoberman et al. is also comparable, but Tähtinen et al. may have overestimated the effect of antibiotics. Their primary outcome 'time to treatment failure' does not take later improvement or recovery into account. In both trials, the greatest benefit is related to otoscopic recovery of AOM, which is clinically not the most relevant outcome. For now, there is no reason to adapt the current AOM practice guideline of the Dutch College of General Practitioners.
authors.affiliation: Huisartsenpraktijk de Hof van Blom, Hattem, the Netherlands. rdamoiseaux@hotmail.com
authors.forename: Roger A M J
authors.initials: RA
authors.lastname: Damoiseaux
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D006801:Humans; D009426:Netherlands; D010033:Otitis Media / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents