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

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

Topical antibiotics vs no topical antibiotic.

Surgical site infection · people presenting for surgery where healing of surgical wound planned to be by primary intention

Topical antibiotics probably leads to lower surgical site infection compared with no topical antibiotic. (moderate certainty).

1 finding from 1 review

Topical antibiotics vs no topical antibiotic.

Allergic contact dermatitis · people presenting for surgery where healing of surgical wound planned to be by primary intention

It is very uncertain whether topical antibiotics changes allergic contact dermatitis compared with no topical antibiotic. (very low certainty).

1 finding from 1 review

Topical antibiotics with steroids vs topical antibiotics

Health‐related quality of life · people (of any age) with chronic suppurative otitis media or ear discharge

The review found no eligible studies for this question.

2 findings from 1 review

Topical antibiotics with steroids vs topical antibiotics

Ear pain (otalgia) or discomfort or local irritation · people (of any age) with chronic suppurative otitis media or ear discharge

It is very uncertain whether topical antibiotics with steroids changes ear pain (otalgia) or discomfort or local irritation compared with topical antibiotics alone (same antibiotics) (very low certainty).

1 finding from 1 review

Topical antibiotics with steroids vs topical antibiotics

Serious complications (including intracranial complications, extracranial complications and death) · people (of any age) with chronic suppurative otitis media or ear discharge

The review found no eligible studies for this question.

2 findings from 1 review

Topical antibiotics with steroids vs topical antibiotics

Resolution of ear discharge ‐ measured at 1 to 2 weeks · people (of any age) with chronic suppurative otitis media or ear discharge

Topical antibiotics with steroids may leads to lower resolution of ear discharge at between 1 to 2 weeks compared with topical antibiotics alone (low certainty).

2 findings from 1 review

Topical antibiotics with steroids vs topical antibiotics

Resolution of ear discharge ‐ measured after 4 weeks · people (of any age) with chronic suppurative otitis media or ear discharge

The review found no eligible studies for this question.

2 findings from 1 review

Topical antibiotics with steroids vs topical antibiotics

Discomfort/pain · people (of any age) with chronic suppurative otitis media or ear discharge

It is very uncertain whether topical antibiotics with steroids changes ear pain or discomfort at 14 weeks compared with topical antibiotics alone (very low certainty).

1 finding from 1 review

Topical antibiotics with steroids vs topical antibiotics

Suspected ototoxicity: dizziness/vertigo/balance · people (of any age) with chronic suppurative otitis media or ear discharge

It is very uncertain whether topical antibiotics with steroids changes suspected ototoxicity: dizziness/vertigo/balance compared with topical antibiotics alone (very low certainty).

1 finding from 1 review