This is not the most recent version of the article. View current version (8 SEP 2010)
Intervention Review
Short-course antibiotics for acute otitis media
Editorial Group: Cochrane Acute Respiratory Infections Group
Published Online: 17 MAR 2010
Assessed as up-to-date: 17 FEB 2000
DOI: 10.1002/14651858.CD001095
Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Database Title
Additional Information
How to Cite
Kozyrskyj A, Klassen TP, Moffatt M, Harvey K. Short-course antibiotics for acute otitis media. Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No.: CD001095. DOI: 10.1002/14651858.CD001095.
Publication History
- Publication Status: Edited (no change to conclusions)
- Published Online: 17 MAR 2010
This is not the most recent version of the article.View current version (08 Sep 2010)
Abstract
Background
Otitis media is a common pediatric problem, for which antibiotics are frequently prescribed.
Objectives
To determine the effectiveness of a short course of antibiotics (less than seven days) in comparison to a longer course (seven days or greater) for the treatment of acute otitis media in children.
Search strategy
The medical literature was searched for randomized controlled studies of the treatment of ear infections in children with antibiotics published from January 1966 to July 1997. Search last updated March 1998.
Selection criteria
Studies were included if they met the following criteria: subjects one month to 18 years of age, clinical diagnosis of ear infection, no previous antimicrobial therapy and randomization to treatment with less than seven days versus seven days or more of antibiotics.
Data collection and analysis
Data on treatment outcomes were extracted from individual studies, and combined in the form of a summary odds ratio. A summary odds ratio (OR) equivalent to one indicated that the treatment failure rate following less than seven days of antibiotic treatment was similar to the failure rate following seven days or more of antibiotic.
Main results
The summary OR for treatment outcomes at eight to 19 days in 1,524 children treated with short-acting antibiotics for five days versus eight to 10 days was 1.52, 95% CI: 1.17-1.98, but by 20 to 30 days outcomes between treatment groups (n=2,115) were comparable (OR=1.22, 95% CI:0.98-1.54). The absolute difference in treatment failure (Random effects model RD=2.9%, 95%CI:-0.3% to 6.1%) at 20 to 30 days suggests that at minimum 17 children would need to be treated with the long course of short-acting antibiotics to avoid one treatment failure. Similarity in outcomes was observed for up to three months following therapy (OR=1.16,95% CI=0.9-1.5). Comparable outcomes were shown between treatment with ceftriaxone or azithromycin, and more than seven days of other antibiotics.
Authors' conclusions
This review suggests that five days of short-acting antibiotic is effective treatment for uncomplicated ear infections in children.
Plain language summary
A short five-day course of antibiotics is as effective as 10 days of treatment for healthy children with uncomplicated middle ear infection (otitis media)
Otitis media (middle ear infection) is very common in childhood, with more than half of all children having at least one infection by the time they are seven. While it seems that usually, otitis media resolves without treatment, it is often treated with antibiotics. The length of treatment varies widely. The review of 30 trials found that, as long as the child was otherwise healthy and not having a problem with recurring ear infections, a short five-day course of antibiotics was as effective as 10 days of antibiotics.