Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

82 questions · 82 findings · 9 reviews · ENT

No studies found 23 · 28%GRADE not reported 0 · 0%Very low 40 · 48.8%Low 12 · 14.6%Moderate 7 · 8.5%High 0 · 0%

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

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

Intranasal steroid spray vs placebo

Adverse event: systemic corticosteroid side effects · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether topical (intranasal) steroids changes adverse event: systemic corticosteroid side effects compared with placebo (very low certainty).

1 finding from 1 review

Intranasal steroid spray vs no treatment

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

It is very uncertain whether topical (intranasal) steroids changes presence/persistence of OME (short‐term); assumed ICC = 0.5 compared with no treatment (very low certainty).

1 finding from 1 review