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Topical vs. systemic treatments for acute otitis media
Kathy Thornton1, Francie Parrish, Christine Swords
1Georgia Southern University School of Nursing, Statesboro, GA, USA.
Pediatric Nursing
|December 3, 2011
Summary
For non-complicated acute otitis media (AOM) in children over two, eardrops are recommended over systemic antibiotics. Evidence supports topical treatments, but many doctors still use oral antibiotics, indicating a need for further research into adherence barriers.
Area of Science:
- Pediatrics
- Otolaryngology
- Evidence-Based Medicine
Background:
- Acute otitis media (AOM) is a frequent childhood illness.
- Systemic antibiotic therapy is the common treatment for AOM.
- Emerging evidence suggests spontaneous resolution with topical treatments for uncomplicated AOM.
Purpose of the Study:
- To compare the efficacy of systemic antibiotics versus topical treatments for AOM.
- To determine the best practice guidelines for AOM management.
- To identify barriers to adopting evidence-based AOM treatment recommendations.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was performed.
- Searches included Cochrane, Medline, and CINAHL databases.
- Studies published between 1995 and 2010 involving children with AOM were included.
Main Results:
- Five systematic reviews and five RCTs were analyzed.
- Current evidence supports topical treatments for non-complicated AOM in children aged 2 years and older.
- A gap exists between recommended practice and current practitioner behavior.
Conclusions:
- Topical treatments and alternative approaches are recommended for non-complicated AOM in children over two.
- Practitioner adherence to guidelines for AOM management needs improvement.
- Further research is needed to understand and address reasons for non-adherence to reduce unnecessary systemic antibiotic use.
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