Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

82 questions · 88 findings · 5 reviews · ENT

No studies found 20 · 22.7%GRADE not reported 2 · 2.3%Very low 28 · 31.8%Low 16 · 18.2%Moderate 18 · 20.5%High 4 · 4.5%

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

Oral steroids 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)

Oral steroids showed no clear difference in hearing ‐ return to normal hearing compared with placebo (moderate certainty).

1 finding from 1 review