Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

85 questions · 92 findings · 6 reviews · ENT

No studies found 37 · 40.2%GRADE not reported 0 · 0%Very low 41 · 44.6%Low 12 · 13%Moderate 2 · 2.2%High 0 · 0%

Antibiotics vs no treatment or placebo on top of topical antibiotics

Resolution of ear discharge ‐ measured after 4 weeks · people with CSOM; one study included patients of unknown age; one study included children with CSOM who had not responded to initial…

It is very uncertain whether systemic antibiotics changes resolution of ear discharge ‐ measured after 4 weeks (4 weeks)… compared with no treatment or placebo on top of topical antibiotics (very low certainty).

2 findings from 1 review

Antibiotics vs placebo

Hearing ‐ return to normal *Ventilation tubes versus laser myringotomy (6 to 12 months ‐ medium‐term) Adjusted for non‐independence of within‐individual measurements Assumed ICC of 0.5 № of participants: 132 (2 RCTs) · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether antibiotics changes hearing ‐ return to normal hearing (as complete improvement in… compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics vs placebo

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether antibiotics changes presence/persistence of OME compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics vs placebo

Adverse event: anaphylaxis · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether antibiotics changes adverse event: anaphylaxis compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics vs no treatment

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

Antibiotics may leads to lower presence/persistence of OME (up to 3 months) № of participants: 542… compared with no treatment (low certainty).

1 finding from 1 review

Antibiotics vs placebo, no treatment or therapy of unproven effectiveness

Complete resolution of OME at 2 to 3 months · Children with otitis media with effusion

Antibiotics probably leads to higher complete resolution of OME at 2 to 3 months compared with placebo, no treatment or therapy of unproven effectiveness (moderate certainty).

2 findings from 1 review

Antibiotics vs placebo, no treatment or therapy of unproven effectiveness

Complete resolution of OME at more than 6 months · Children with otitis media with effusion

Antibiotics may leads to higher complete resolution of OME at more than 6 months compared with placebo, no treatment or therapy of unproven effectiveness (low certainty).

1 finding from 1 review

Antibiotics vs no treatment or placebo on top of topical antibiotics

Ear pain (otalgia) or discomfort or local irritation · people (of any age) with CSOM

It is very uncertain whether systemic antibiotics changes ear pain (otalgia) or discomfort or local irritation ‐ measured at 1… compared with no treatment or placebo on top of topical antibiotics (very low certainty).

1 finding from 1 review

Antibiotics vs no treatment or placebo on top of topical antibiotics

Suspected ototoxicity · people (of any age) with CSOM

It is very uncertain whether systemic antibiotics changes suspected ototoxicity ‐ measured at 10 days to 3 weeks compared with no treatment or placebo on top of topical antibiotics (very low certainty).

1 finding from 1 review