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
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
Current version onlyAntibiotics versus placebo for acute otitis media in children
Population: children with acute otitis media
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain ‐ pain at 24 hours Antibiotics vs placebo | RR 0.89 [0.78, 1.01] | 5 studies · 1394 participants | High |
Pain ‐ pain at 2 to 3 days Antibiotics vs placebo | RR 0.71 [0.58, 0.88] | 7 studies · 2320 participants | High |
Pain ‐ pain at 4 to 7 days Antibiotics vs placebo | RR 0.76 [0.5, 1.14] | 7 studies · 1264 participants | High |
Pain ‐ pain at 10 to 12 days Antibiotics vs placebo | RR 0.33 [0.17, 0.66] | 1 study · 278 participants | Moderate Downgraded: inconsistency |
Vomiting, diarrhoea or rash Antibiotics vs placebo | RR 1.38 [1.16, 1.63] | 8 studies · 2107 participants | High |
Abnormal tympanometry ‐ 2 to 4 weeks Antibiotics vs placebo | RR 0.83 [0.72, 0.96] | 7 studies · 2138 participants | High |
Abnormal tympanometry ‐ 3 months Antibiotics vs placebo | RR 0.94 [0.66, 1.34] | 3 studies · 809 participants | High |
Immediate antibiotics versus expectant observation for acute otitis media in children
Population: children with acute otitis media
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain ‐ Pain at 2 to 3 days Immediate antibiotics vs expectant observation | RR 0.53 [0.35, 0.79] | 1 study · 396 participants | Low 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 participants | Moderate 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 participants | Low Downgraded: risk of bias |
Vomiting, diarrhoea or rash Immediate antibiotics vs expectant observation | RR 1.87 [1.39, 2.51] | 3 studies · 946 participants | High |
Abnormal tympanometry at 4 weeks Immediate antibiotics vs expectant observation | RR 1.03 [0.78, 1.35] | 1 study · 207 participants | Moderate Downgraded: risk of bias |
Antibiotics versus placebo for acute otitis media in children
Population: children with acute otitis media
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain ‐ pain at 24 hours Antibiotics vs placebo | RR 0.89 [0.78, 1.01] | 5 studies · 1394 participants | High |
Pain ‐ pain at 2 to 3 days Antibiotics vs placebo | RR 0.7 [0.57, 0.86] | 7 studies · 2320 participants | High |
Pain ‐ pain at 4 to 7 days Antibiotics vs placebo | RR 0.76 [0.63, 0.91] | 7 studies · 1347 participants | High |
Pain ‐ pain at 10 to 12 days Antibiotics vs placebo | RR 0.33 [0.17, 0.66] | 1 study · 278 participants | Moderate Downgraded: imprecision |
Abnormal tympanometry ‐ 2 to 4 weeks Antibiotics vs placebo | RR 0.82 [0.74, 0.9] | 7 studies · 2138 participants | High |
Abnormal tympanometry ‐ 3 months Antibiotics vs placebo | RR 0.97 [0.76, 1.24] | 3 studies · 809 participants | High |
Vomiting, diarrhoea or rash Antibiotics vs placebo | RR 1.38 [1.19, 1.59] | 8 studies · 2107 participants | High |
Comparison
Population: children with acute otitis media
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain at 24 hours | RR 0.89 [0.78, 1.01] | 6 studies · 1394 participants | High |
Pain at 2 to 3 days | RR 0.7 [0.57, 0.86] | 7 studies · 2320 participants | High |
Pain at 4 to 7 days | RR 0.79 [0.66, 0.95] | 7 studies · 1263 participants | High |
Abnormal tympanometry ‐ 4 to 6 weeks | RR 0.92 [0.83, 1.01] | 7 studies · 2144 participants | High |
Abnormal tympanometry ‐ 3 months | RR 0.97 [0.76, 1.24] | 3 studies · 809 participants | High |
Vomiting, diarrhoea or rash | RR 1.34 [1.16, 1.55] | 7 studies · 2023 participants | High |
Comparison
Population: patients with acute otitis media in children
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain ‐ Pain at 24 hours | RR 0.9 [0.78, 1.04] | 5 studies · 1229 participants | High |
Pain ‐ Pain at 2 to 7 days | RR 0.72 [0.62, 0.83] | 10 studies · 2791 participants | High |
Abnormal tympanometry ‐ 1 month | RR 0.89 [0.75, 1.07] | 4 studies · 927 participants | High |
Abnormal tympanometry ‐ 3 months | RR 0.97 [0.76, 1.24] | 3 studies · 808 participants | High |
Vomiting, diarrhoea, or rash | RR 1.38 [1.09, 1.76] | 5 studies · 1401 participants | Moderate |