Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

181 questions · 190 findings · 14 reviews · Headline outcomes only

No studies found 92 · 48.4%GRADE not reported 1 · 0.5%Very low 64 · 33.7%Low 25 · 13.2%Moderate 7 · 3.7%High 1 · 0.5%

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 antibiotics

Resolution of ear discharge ‐ measured at 1 to 2 weeks · people (of any age) with CSOM

Systemic antibiotics showed no clear difference in resolution of ear discharge ‐ measured at 1 to 2 weeks compared with no treatment or placebo on top of topical antibiotics (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

Oral or topical or intraperitoneal antibiotics vs placebo/no treatment

Peritonitis · chronic peritoneal dialysis patients

Oral or topical or intraperitoneal antibiotics showed no clear difference in peritonitis (number of patients with one or more episodes) compared with placebo/no treatment (low certainty).

1 finding from 1 review