What do systematic reviews say?

Intranasal steroid spray vs control

Summary of findings: intranasal steroids showed no clear difference in adverse effects [3 months] compared with control (low certainty).

• Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children 2011 · Cochrane Headline outcomes only
  RR 1.26 [0.8, 1.99]
  2 studies · 231 participants
  Low

Summary of findings: intranasal steroids plus oral antibiotic vs control plus antibiotic

• Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children 2011 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 59 participants
  GRADE not reported

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Summary of findings: oral steroids plus antibiotic showed no clear difference in adverse effects [2 weeks to 6 months] compared with control plus antibiotic (low certainty).

• Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children 2011 · Cochrane Headline outcomes only
  RR 1.5 [0.81, 2.78]
  2 studies · 255 participants
  Low

Tacrolimus 0.1% vs corticosteroids

Tacrolimus 0.1% probably leads to higher adverse effects: burning ‐ tacrolimus 0.1% versus hydrocortisone… compared with corticosteroids (moderate certainty).

• Topical tacrolimus for atopic dermatitis 2015 · Cochrane Headline outcomes only
  RR 3.79 [2.99, 4.81]
  1 study · 972 participants
  Moderate