Cochrane · systematic review · CD000219

Antibiotics for acute otitis media in children

Venekamp, RP, Sanders, SL, Glasziou, PP, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Acute Respiratory Infections4 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 16.7%Moderate 3 · 25%High 7 · 58.3%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 4 versions

Antibiotics versus placebo for acute otitis media in children

Population: children with acute otitis media
7 questions
OutcomeEffectEvidenceStatus / GRADE
Pain ‐ pain at 24 hours
Antibiotics vs placebo
RR 0.89 [0.78, 1.01]5 studies · 1394 participantsHigh
Pain ‐ pain at 2 to 3 days
Antibiotics vs placebo
RR 0.71 [0.58, 0.88]7 studies · 2320 participantsHigh
Pain ‐ pain at 4 to 7 days
Antibiotics vs placebo
RR 0.76 [0.5, 1.14]7 studies · 1264 participantsHigh
Pain ‐ pain at 10 to 12 days
Antibiotics vs placebo
RR 0.33 [0.17, 0.66]1 study · 278 participantsModerate
Downgraded: inconsistency
Vomiting, diarrhoea or rash
Antibiotics vs placebo
RR 1.38 [1.16, 1.63]8 studies · 2107 participantsHigh
Abnormal tympanometry ‐ 2 to 4 weeks
Antibiotics vs placebo
RR 0.83 [0.72, 0.96]7 studies · 2138 participantsHigh
Abnormal tympanometry ‐ 3 months
Antibiotics vs placebo
RR 0.94 [0.66, 1.34]3 studies · 809 participantsHigh

Immediate antibiotics versus expectant observation for acute otitis media in children

Population: children with acute otitis media
5 questions
OutcomeEffectEvidenceStatus / GRADE
Pain ‐ Pain at 2 to 3 days
Immediate antibiotics vs expectant observation
RR 0.53 [0.35, 0.79]1 study · 396 participantsLow
Downgraded: risk of bias, imprecision
Pain ‐ Pain at 3 to 7 days
Immediate antibiotics vs expectant observation
RR 0.75 [0.5, 1.12]4 studies · 959 participantsModerate
Downgraded: risk of bias
Pain ‐ Pain at 11 to 14 days
Immediate antibiotics vs expectant observation
RR 0.91 [0.75, 1.1]1 study · 247 participantsLow
Downgraded: risk of bias
Vomiting, diarrhoea or rash
Immediate antibiotics vs expectant observation
RR 1.87 [1.39, 2.51]3 studies · 946 participantsHigh
Abnormal tympanometry at 4 weeks
Immediate antibiotics vs expectant observation
RR 1.03 [0.78, 1.35]1 study · 207 participantsModerate
Downgraded: risk of bias