Acute Otitis Media and Antibiotics
The purpose of this study published in the British Medical Journal 1997 was to determine the effect of antibiotic treatment for acute otitis media in children.
The researchers underwent a systematic search of the medical literature to identify studies that used antibiotics in randomised controlled trials to treat acute otitis media. This resulted in six studies of children aged seven months to fifteen years.
60% of placebo treated children were pain free within 24 hours of presentation, and antibiotics did not influence this.
At 2-7 days after presentation, by which time only 14% of children in control groups still had pain, early use of antibiotics reduced the risk of pain by 41%.
Antibiotics reduced contralateral acute otitis media by 43% (9% to 64%).
They seemed to have no influence on subsequent attacks of otitis media or deafness at one month, although there was a trend for improvement of deafness at three months.
Antibiotics were associated with a near doubling of the risk of vomiting, diarrhoea, or rashes.
The study concluded that “early use of antibiotics provides only modest benefit for acute otitis media: to prevent one child from experiencing pain by 2-7 days after presentation, 17 children must be treated with antibiotics early.”
British Medical Journal 1997; 314 (7093) 24 May: 1526–1529 Christopher Del Mar, Paul Glasziou, Mauricio Hayem
This study questions the early use of antibiotics for children with acute ear infections.