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Latest & greatest articles for otitis media
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Ventilation tubes after surgery for otitismedia with effusion or acute otitismedia and swimming: systematic review and meta-analysis Ventilation tubes after surgery for otitismedia with effusion or acute otitismedia and swimming: systematic review and meta-analysis Ventilation tubes after surgery for otitismedia with effusion or acute otitismedia and swimming: systematic review and meta-analysis Carbonell R, Ruiz-Garcia V Authors' objectives To determine whether swimming using ear (...) protection, swimming without ear protection and not swimming affects the risk of acute otitismedia (AOM) in children with ventilation tubes. Searching MEDLINE (from 1966 to June 2001), EMBASE (from 1980 to June 2001) and the Cochrane Library (to June 2001) were searched without language restriction. In addition, the reference lists from identified studies were checked. Experts were not contacted and grey literature was not sought. A brief summary of the search strategy was reported in the review. Study
Predictors of poor outcome and benefits from antibiotics in children with acute otitismedia: pragmatic randomised trial. To identify which children with acute otitismedia are at risk of poor outcome and to assess benefit from antibiotics in these children.Secondary analysis of randomised controlled trial cohort.Primary care.315 children aged 6 months to 10 years.Immediate or delayed (taken after 72 hours if necessary) antibiotics.Predictors of short term outcome: an episode of distress (...) was less likely with immediate antibiotics (32% for immediate v 53% for delayed, chi2=4.0; P=0.045, number needed to treat 5) as was night disturbance (26% v 59%, chi2=9.3; P=0.002; number needed to treat 3). In children without higher temperature or vomiting, immediate antibiotics made little difference to distress by day three (15% v 19%, chi2=0.74; P=0.39) or night disturbance (20% v 27%, chi2=1.6; P=0.20). Addition of cough did not significantly improve prediction of benefit.In children with otitis
Evidence assessment of management of acute otitismedia - I. The role of antibiotics in treatment of uncomplicated acute otitismedia Evidence assessment of management of acute otitismedia - I. The role of antibiotics in treatment of uncomplicated acute otitismedia Evidence assessment of management of acute otitismedia - I. The role of antibiotics in treatment of uncomplicated acute otitismedia Takata G S, Chan L S, Shekelle P, Morton S C, Mason W, Marcy S M Authors' objectives (...) To synthesise the literature on the natural history of acute otitismedia (AOM), the effectiveness of antibiotic treatment in uncomplicated AOM, and the relative effectiveness of specific antibiotic regimens. Searching The following sources were searched: MEDLINE from 1966 to March 1999; the Cochrane Library (to March 1999); HealthSTAR from 1975 to March 1999; International Pharmaceutical Abstracts from 1970 to March 1999; CINAHL from 1982 to March 1999; BIOSIS Previews from 1970 to March 1999; and EMBASE
Management of acute otitismedia Management of acute otitismedia Management of acute otitismedia Marcy M, Takata G, Chan L S Shekelle P, Mason W, Wachsman L, Ernst R, Hay J W, Corley P M, Morphew T, Ramicone E, Nicholson C Authors' objectives To analyse the evidence on the initial management of uncomplicated acute otitismedia (AOM) in children, and to assess the following three questions. What is the natural history of AOM without antibiotic treatment? Are antibiotics effective in preventing (...) to establish differences in antibiotic efficacy. In addition, future studies should address the issue of bacterial resistance. Bibliographic details Marcy M, Takata G, Chan L S Shekelle P, Mason W, Wachsman L, Ernst R, Hay J W, Corley P M, Morphew T, Ramicone E, Nicholson C. Management of acute otitismedia. Rockville, MD, USA: Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment; 15. 2001 Original Paper URL Other publications of related interest Jadad AR, Moore RA, Carroll D
Management of acute otitismedia Management of acute otitismedia Management of acute otitismedia Agency for Healthcare Research and Quality (AHRQ) Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Agency for Healthcare Research and Quality (AHRQ). Management of acute otitismedia. Rockville: Agency for Healthcare Research and Quality (...) (AHRQ). Evidence Report/Technology Assessment No. 15. 2001 Authors' objectives The objective of this report is to analyze the evidence on the initial management of uncomplicated acute otitismedia (AOM) in children. Authors' conclusions There is a wide range of reported clinical failure rates in the first week in children with AOM who are not treated with antibiotics. The pooled estimates indicate that a majority of these children have clinical resolution within the first week after presentation
Azithromycin vs. clarithromycin and co-amoxiclav: clinical and economic comparison in the treatment of acute otitismedia in children Azithromycin vs. clarithromycin and co-amoxiclav: clinical and economic comparison in the treatment of acute otitismedia in children Azithromycin vs. clarithromycin and co-amoxiclav: clinical and economic comparison in the treatment of acute otitismedia in children Kawalski H, Blacha E, Kopacz M, Mos M, Cierpiol-Tracz E, Welniak M, Dudziak B, Bojda S, Kossowska (...) B, Gatniejewska E, Ligacz M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of azithromycin, clarithromycin and co-amoxiclav in the treatment of children with acute otitismedia (AOM). Azithromycin was administered
Effect of recolonisation with "interfering" alpha streptococci on recurrences of acute and secretory otitismedia in children: randomised placebo controlled trial. To study the effect of recolonisation with alpha streptococci with the ability to inhibit the growth of otopathogens ("interfering" activity) on the recurrence of acute otitismedia in susceptible children and the effect on the frequency of secretory otitis media.Double blind, randomised, placebo controlled study.Ear, nose (...) , and throat clinic with three doctors.130 children prone to otitismedia aged between 6 months and 6 years, 108 of whom were eligible and followed for 3 months.Recurrence of otitismedia during follow up and a normal tympanic membrane at the last valid visit.Children with no recurrences during the last month received phenoxymethylpenicillin (n=22), and those with a recurrence within 1 month received amoxicillin clavulanic acid (n=86), both twice daily for 10 days. These were followed by a streptococcal
Pragmatic randomised controlled trial of two prescribing strategies for childhood acute otitismedia. To compare immediate with delayed prescribing of antibiotics for acute otitis media.Open randomised controlled trial.General practices in south west England.315 children aged between 6 months and 10 years presenting with acute otitis media.Two treatment strategies, supported by standardised advice sheets-immediate antibiotics or delayed antibiotics (antibiotic prescription to be collected (...) mainly after first 24 hours, when symptoms were already resolving. For children who are not very unwell systemically, a wait and see approach seems feasible and acceptable to parents and should substantially reduce the use of antibiotics for acute otitismedia.
Effect of early or delayed insertion of tympanostomy tubes for persistent otitismedia on developmental outcomes at the age of three years. A main indication for the insertion of tympanostomy tubes in infants and young children is persistent otitismedia with effusion, reflecting concern that this condition may cause lasting impairments of speech, language, cognitive, and psychosocial development. However, evidence of such relations is inconclusive, and evidence is lacking that the insertion (...) +/-7 vs. 86+/-7); the General Cognitive Index of McCarthy Scales of Children's Abilities (99+/-14 vs. 101+/-13); or on measures of receptive language, sentence length, grammatical complexity, parent-child stress, and behavior.In children younger than three years of age who have persistent otitismedia, prompt insertion of tympanostomy tubes does not measurably improve developmental outcomes at the age of three years.
Efficacy of a pneumococcal conjugate vaccine against acute otitismedia. Ear infections are a common cause of illness during the first two years of life. New conjugate vaccines may be able to prevent a substantial portion of cases of acute otitismedia caused by Streptococcus pneumoniae.We enrolled 1662 infants in a randomized, double-blind efficacy trial of a heptavalent pneumococcal polysaccharide conjugate vaccine in which the carrier protein is the nontoxic diphtheria-toxin analogue CRM197 (...) . The children received either the study vaccine or a hepatitis B vaccine as a control at 2, 4, 6, and 12 months of age. The clinical diagnosis of acute otitismedia was based on predefined criteria, and the bacteriologic diagnosis was based on a culture of middle-ear fluid obtained by myringotomy.Of the children who were enrolled, 95.1 percent completed the trial. With the pneumococcal vaccine, there were more local reactions than with the hepatitis B vaccine but fewer than with the combined whole-cell
Oral or topical nasal steroids for hearing loss associated with otitismedia with effusion in children. OME is common and may cause hearing loss with associated developmental delay. Treatment remains controversial. The effect of both systemic and intra-nasal steroids on effusions has been assessed by randomised controlled trials.To examine evidence for or against treating children with hearing loss associated with OME with systemic or topical nasal steroids.Searches were conducted in February (...) 2000. We searched the Cochrane Controlled Trials Register using the terms 'otitis-media', 'otitismedia with effusion', 'glue ear', or 'OME', and 'steroids', 'glucocorticoids, synthetic', 'glucocorticoids, topical', 'anti-inflammatory agents, steroidal'. EMBASE and MEDLINE were also searched for additional information.Randomised controlled trials of oral and topical nasal steroids, either alone or in combination with another agent such as an antibiotic, were included.publications in abstract form
Interventions for chronic suppurative otitismedia. Chronic suppurative otitismedia (CSOM) is a serious bacterial infection of the middle ear that can follow untreated acute otitis media.To assess the effects of different treatments for CSOM.We searched Medline from 1966 to 1996 and a bibliographic collection of the Hearing Impairment Research Group in Liverpool, UK. We handsearched two otolaryngology journals and contacted members of an international hearing network.Randomized trials of any
Antibiotics for acute otitismedia in children. Acute otitismedia is one of the most common diseases in early infancy and childhood. Antibiotic use for acute otitismedia varies from 31% in the Netherlands to 98% in the USA and Australia.The objective of this review was to assess the effects of antibiotics for children with acute otitis media.We searched the Cochrane Controlled Trials Register, MEDLINE, Index Medicus (pre 1965), Current Contents and reference lists of articles from 1958 (...) interval 15% to 38%) in pain at two to seven days. Since approximately 80% of patients will have settled spontaneously in this time, this means an absolute reduction of 5% or that about 17 children must be treated with antibiotics to prevent one child having some pain after two days. There was no effect of antibiotics on hearing problems of acute otitismedia, as measured by subsequent tympanometry. However, audiometry was done in only two studies and incompletely reported. Nor did antibiotics
Childhood vaccination against pneumococcal otitismedia and pneumonia: an analysis of benefits and costs Childhood vaccination against pneumococcal otitismedia and pneumonia: an analysis of benefits and costs Childhood vaccination against pneumococcal otitismedia and pneumonia: an analysis of benefits and costs Weycker D, Richardson E, Oster G Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of a heptavalent pneumococcal conjugate vaccine (PNCRM7) in children aged younger than 5 years, for the prevention of acute otitismedia (AOM), community-acquired pneumonia (CAP), and tympanostomy and related procedures (TRP). Type of intervention Primary prevention (paediatric vaccination). Economic study type Cost
Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitismedia in children aged under 2 years. To determine the effect of antibiotic treatment for acute otitismedia in children between 6 months and 2 years of age.Practice based, double blind, randomised, placebo controlled trial.53 general practices in the Netherlands.240 children aged 6 months to 2 years with the diagnosis of acute otitis media.Amoxicillin 40 mg/kg/day in three doses.Persistent symptoms (...) in the placebo group during the first 10 days (4.1 v 2.3 doses, P=0.004). In addition, no otoscopic differences were observed at days four and 11, and tympanometric findings at six weeks were similar in both groups.Seven to eight children aged 6 to 24 months with acute otitismedia needed to be treated with antibiotics to improve symptomatic outcome at day four in one child. This modest effect does not justify prescription of antibiotics at the first visit, provided close surveillance can be guaranteed.
Treatment of acute otitismedia with an antiadhesive oligosaccharide: a randomised, double-blind, placebo-controlled trial. Antiadhesive compounds are promising candidates for prevention or treatment of infections. We have investigated the efficacy of such an agent, 3'-sialyllacto-N-neotetraose (NE-1530), given intranasally for prophylaxis of acute otitismedia and for effect on nasopharyngeal carriage of bacteria.We did a randomised, double-blind placebo-controlled study at one study site. 507 (...) of acute otitismedia was diagnosed in 108 (43%) of 254 children in the NE-1530 group and in 86 (34%) of 253 children in the placebo group. The efficacy of treatment was negative, -27% (95% CI -68 to 5; p=0.10). The nasopharyngeal carriage of S pneumoniae, H. influenzae, and M. catarrhalis was not affected by treatment, and the adverse event profiles were almost identical for NE-1530 and placebo.NE-1530 did not have a beneficial effect on the occurrence of acute otitismedia or on the nasopharyngeal
2000LancetControlled trial quality: predicted high
Adenoidectomy and adenotonsillectomy for recurrent acute otitismedia: parallel randomized clinical trials in children not previously treated with tympanostomy tubes. Adenoidectomy and adenotonsillectomy are commonly performed in US children to reduce the occurrence of persistent or recurrent otitismedia, but evidence supporting the efficacy of the operations is limited.To test the efficacy of adenoidectomy and adenotonsillectomy in children with persistent or recurrent otitismedia who had (...) an adenoidectomy, adenotonsillectomy, or control group; children who had such conditions (157 enrolled; 144 followed up) were randomized to an adenotonsillectomy or control group.Occurrence rate of episodes of acute otitismedia by treatment group and estimated proportion of time with otitis media.In both trials, most subjects were eligible because of recurrent acute otitismedia, with or without persistent otitismedia with effusion. A total of 47 children assigned to surgical treatment groups had no surgery
Treatment of acute otitismedia with a shortened course of antibiotics: a meta-analysis. To conduct a meta-analysis of randomized controlled trials of antibiotic treatment of acute otitismedia in children to determine whether outcomes were comparable in children treated with antibiotics for less than 7 days or at least 7 days or more.MEDLINE (1966-1997), EMBASE (1974-1997), Current Contents, and Science Citation Index searches were conducted to identify randomized controlled trials (...) of the treatment of acute otitismedia in children with antibiotics of different durations.Studies were included if they met the following criteria: subjects aged 4 weeks to 18 years, clinical diagnosis of acute otitismedia, no antimicrobial therapy at time of diagnosis, and randomization to less than 7 days of antibiotic treatment vs 7 days or more of antibiotic treatment.Trial methodological quality was assessed independently by 7 reviewers; outcomes were extracted as the number of treatment failures
Screening programmes for the detection of otitismedia with effusion and conductive hearing loss in pre-school and new entrant school children: a critical appraisal of the literature Screening programmes for the detection of otitismedia with effusion and conductive hearing loss in pre-school and new entrant school children: a critical appraisal of the literature Screening programmes for the detection of otitismedia with effusion and conductive hearing loss in pre-school and new entrant school (...) children: a critical appraisal of the literature New Zealand Health Technology Assessment Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation New Zealand Health Technology Assessment. Screening programmes for the detection of otitismedia with effusion and conductive hearing loss in pre-school and new entrant school children: a critical appraisal
Antibiotic treatment of acute otitismedia in children under two years of age: evidence based? Antibiotic treatment of acute otitismedia in children under two years of age: evidence based? Antibiotic treatment of acute otitismedia in children under two years of age: evidence based? Damoiseaux R A, van Balen F A, Hoes A W, De Melker R A Authors' objectives To assess whether the current high prescription rates of antibiotics for acute otitismedia (AOM) in children under two years of age (being (...) a risk group for poor outcome) are based on an established increased efficacy. Searching MEDLINE (1966 to January 1997) and EMBASE (1974 to January 1997) were searched using the following keywords; otitismedia, child, clinical trial, and placebo. The reference sections of these articles and of several major review articles were checked for further articles. An extensive handsearch for clinical trials of therapy for AOM in patients of all ages was performed by the authors' group in 1991 (see Other