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Management of Acute Otitis Media: update
Evidence Report/Technology Assessment
|November 7, 2012
Summary
This review updates evidence on acute otitis media (AOM) diagnosis and treatment. While ampicillin/amoxicillin show modest benefits for uncomplicated AOM, PCV7 vaccine use has shifted AOM microbiology, necessitating further research.
Area of Science:
- Pediatrics
- Infectious Diseases
- Evidence-Based Medicine
Background:
- Acute Otitis Media (AOM) is a common childhood infection often treated with antibiotics.
- A 2001 systematic review previously assessed AOM treatments.
Purpose of the Study:
- To update findings on uncomplicated AOM diagnosis and treatment.
- To evaluate treatments for recurrent AOM.
- To assess the impact of the pneumococcal conjugate vaccine (PCV7) on AOM microbiology.
Main Methods:
- Systematic review of existing literature and randomized controlled trials (RCTs) from 1998-2010.
- Searches of PubMed, Cochrane, and Web of Science databases.
- Pooled analysis for comparisons with three or more trials.
Main Results:
- PCV7 vaccine introduction significantly altered AOM microbiology, increasing Haemophilus influenzae prevalence.
- For uncomplicated AOM, ampicillin or amoxicillin showed a modest clinical success benefit over placebo.
- Delayed treatment for uncomplicated AOM yielded mixed results; some studies showed higher success with immediate antibiotics, others did not.
Conclusions:
- Evidence is insufficient for definitive conclusions on recurrent AOM treatment or subgroup analyses for uncomplicated AOM.
- Long-term antibiotic use for recurrent AOM can decrease episodes but carries potential consequences.
- Higher quality studies are needed to clarify optimal AOM and recurrent AOM treatment strategies.
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