Article title: Antibiotics for acute otitis media in children

Journal: Cochrane Database of Systematic Reviews

Authors: Venekamp, et al

This is a systematic review that looked at 5 randomized controlled trials that attempted to assess the effects of antibiotics for children with acute otitis media. It looked at the use of immediate antibiotics vs. expectant observation. The first outcome it looked at was pain. At 3-7 days, there was no difference in pain detectable between the 2 groups. The next outcome was complications. There was no difference noted between the number of tympanic membrane perforations and recurrence of otitis media between the groups. The last outcome was adverse effects. There was a substantial increase in adverse effects with the antibiotic group, leading to an increased risk of vomiting, diarrhea and rash. It concluded that antibiotics have no early effect on pain. It found that antibiotics are most useful in children under 2 years old with B/L AOM or with AOM and otorrhea. Therefore, it is concluded that for most children with a mild disease, expectant observational therapy would be appropriate. The quality of evidence used for this review was deemed to be moderate quality. Further research with high quality evidence can have an important effect on the confidence of the results.

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