Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years

Abstract

Objective To determine the effect of antibiotic treatment for acute otitis media in children between 6 months and 2 years of age.

Principles of Judicious Antibiotic Prescribing for Upper Respiratory Tract Infections in Pediatrics

“…[18][19][20][29][30][31][32][33] Collectively, these have emphasized the following: (1) at least half of patients with AOM will recover without antibiotic therapy; (2) recovery is more likely and is hastened for children who receive antibiotic therapy compared with placebo; and (3) recovery without antibiotic therapy is less likely for younger children, those with bilateral versus unilateral disease, and those with more severe signs and symptoms. These observations underlie the rationale for treatment recommendations for AOM.…”

Antibiotics for acute otitis media in children

“…Twelve trials were double-blind, placebo-controlled, parallelgroup randomised clinical trials (Appelman 1991;Burke 1991;Damoiseaux 2000;Halsted 1968;Hoberman 2011;Howie 1972;Kaleida 1991;Le Saux 2005;Mygind 1981;Tähtinen 2011;Tapiainen 2014;Thalin 1985), while one trial had a 2 x 2 factorial design (van Buchem 1981a andvan Buchem 1981b).…”

Ear discharge in children presenting with acute otitis media: observational study from UK general practice

“…While antibiotics may benefit some children, pain relief is not immediate, the average reduction in duration of pain is only a few hours, and there is no impact on long-term hearing or ear, nose, and throat (ENT) referrals. [2][3][4][5][6][7][8][9][10] However, the NICE guidance does recommend that GPs should 'consider' immediate antibiotic treatment for two groups of children with acute otitis media -the very young (age <2 years) and those with ear discharge. The stated justification for the latter is that a posthoc meta-analysis of the clinical trial data suggests that only three children need to be treated for one less child to experience pain or fever at the 3-7-day assessment point.…”