Antibiotics for acute otitis media: a meta-analysis with individual patient data

Rovers, Maroeska M.; Glasziou, Paul; Appelman, C. L. M.; Burke, Peter; McCormick, David P.; Damoiseaux, Roger; Gaboury, Isabelle; Little, Paul; Hoes, Arno W.

doi:10.1016/s0140-6736(06)69606-2

Cited by 277 publications

(203 citation statements)

References 25 publications

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“…57 Antibiotic therapy of AOM does not provide symptomatic relief in the first 24 hours 58-61 and even after 3 to 7 days, there may be persistent pain, fever, or both in 30% of children younger than 2 years. 62 In contrast, analgesics do relieve pain associated with AOM within 24 hours 63 and should be used whether antibiotic therapy is or is not prescribed; they should be continued as long as needed. The AAP published the policy statement "The Assessment and Management of Acute Pain in Infants, Children, and Adolescents" 64 to assist the clinician in addressing pain in the context of illness.…”

Section: Treatment Of Otalgiamentioning

confidence: 99%

“…A common feature of both approaches was to prioritize initial antibiotic therapy according to diagnostic certainty, with greater reliance on observation when the diagnosis was uncertain. In response to criticism that allowing an "uncertain 62 and the effect of antibiotics on asymptomatic MEE after therapy. 80 Observational studies provide additional data on outcomes of initial observation with delayed antibiotic therapy, if needed, 81 and on the relationship of previous antibiotic therapy for AOM to subsequent acute mastoiditis.…”

Section: Changes From Previous Aom Guidelinementioning

confidence: 99%

“…Greater benefit of immediate antibiotic therapy was observed for bilateral AOM 62,96 or AOM associated with otorrhea. 62 In most randomized trials, 30,75,77,88,89 antibiotic therapy also decreased the duration of pain, analgesic use, or school absence and parent days missed from work.…”

Section: Initial Antibiotic Therapymentioning

confidence: 99%

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The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,062

832

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This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships.The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Pediatrics 2013;131:e964-e999

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Section: Treatment Of Otalgiamentioning

confidence: 99%

Section: Changes From Previous Aom Guidelinementioning

confidence: 99%

See 1 more Smart Citation

The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,062

832

View full text Add to dashboard Cite

show abstract

“…Es interesante destacar el esfuerzo realizado en esta revisión, por analizar el efecto sobre algunos subgrupos que pueden beneficiarse 8 . Una revisión de nuestro grupo analiza los aspectos a considerar al momento de leer un análisis de subgrupo 3 .…”

Section: Comentarios Acerca De Los Resultadosunclassified

“…En segundo lugar debemos fi jarnos en el modo de analizar los datos: • El mismo grupo de autores reporta en otra publicación el resultado detallado del metanálisis de paciente individual ya mencionado (8). Ahí se describe claramente, mediante un test de interacción, que la diferencia entre algunos subgrupos es signifi cativa.…”

Section: Comentarios Acerca De Los Resultadosunclassified