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Routine Antimicrobial Treatment of Acute Otitis Media

Routine Antimicrobial Treatment of Acute Otitis Media EVIDENCE THAT routine antimicrobial treatment improves the course and outcomes after acute otitis media is weak. Given the lack of evidence for benefit and the potential for adverse effects, including altering normal respiratory flora and development of resistant organisms, routine treatment using 10 days of antimicrobials for all cases of acute otitis media is not warranted. See also p 1640. There have been 7 randomized, blinded, placebo-controlled trials of acute otitis media over the past 30 years. Neither short- nor long-term differences were demonstrated in 3,1-3 and minor differences noted in the other 4 studies were limited to short-term benefits of antimicrobials.4-7 In a study by Howie and Ploussard,4 all case patients receiving placebo were asymptomatic at early follow-up (2 to 7 days) but had more positive tympanocentesis cultures than those receiving antimicrobials. Mygind et al5 found decreased pain in the penicillin group compared with the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Routine Antimicrobial Treatment of Acute Otitis Media

JAMA , Volume 278 (20) – Nov 26, 1997

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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1997.03550200019007
Publisher site
See Article on Publisher Site

Abstract

EVIDENCE THAT routine antimicrobial treatment improves the course and outcomes after acute otitis media is weak. Given the lack of evidence for benefit and the potential for adverse effects, including altering normal respiratory flora and development of resistant organisms, routine treatment using 10 days of antimicrobials for all cases of acute otitis media is not warranted. See also p 1640. There have been 7 randomized, blinded, placebo-controlled trials of acute otitis media over the past 30 years. Neither short- nor long-term differences were demonstrated in 3,1-3 and minor differences noted in the other 4 studies were limited to short-term benefits of antimicrobials.4-7 In a study by Howie and Ploussard,4 all case patients receiving placebo were asymptomatic at early follow-up (2 to 7 days) but had more positive tympanocentesis cultures than those receiving antimicrobials. Mygind et al5 found decreased pain in the penicillin group compared with the

Journal

JAMAAmerican Medical Association

Published: Nov 26, 1997

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