Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,756 questions · 13,493 findings · 1,305 reviews · Headline outcomes only

No studies found 2,594 · 19.2%GRADE not reported 728 · 5.4%Very low 2,868 · 21.3%Low 3,777 · 28%Moderate 2,620 · 19.4%High 906 · 6.7%

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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

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 no treatment or placebo on top of topical antibiotics

Serious complications ‐ mastoid abscess measured at 12 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 serious complications ‐ mastoid abscess measured at 12 weeks 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 antiseptics

Resolution of ear discharge ‐ measured after 4 weeks · schoolchildren with CSOM

It is very uncertain whether systemic antibiotics changes resolution of ear discharge (4 weeks or more) ‐ measured at 3 to 4… compared with no treatment or placebo on top of topical antiseptics (very low certainty).

1 finding from 1 review