Table 32Summary of Findings from Articles Each Reporting Effectiveness of Interventions in Uncomplicated Otitis Media Stratified by a Risk Factor

(A) Hearing deficit and severity
Comp #ComparisonArticlePatient PopulationInterventionFindingsConclusion
1Amox-clav vs. CefprozilHedrick, 2001766 months–7 years
Multi-centers in U.S.
Amoxicillin-clavulanate 90/6.4 mg/kg/day/bid for 10 days
vs.
Cefprozil 30 mg/kg/day/bid for 10 days
Outcome: Clinical success (cure or improved) at day 4–7 after treatment by SeverityNot enough evidence to conclude
A-CCefprozilDiff (95% CI)
Moderate92% (83/90)85% (64/75)7% (−2.7, 17)
Severe82% (32/39)88% (45/51)−6% (−21, 9)
Diff (95% CI)10% (−2, 22)−3% (−15, 9)
(B) Otorrhea
Comp #ComparisonArticlePatient PopulationInterventionFindingsConclusion
1Amoxicillin vs. ErythromycinScholz, 199846 months–11 years
19 centers in Germany Pediatric practice
Amoxicillin 50 mg/kg/day/bid for 10 days
vs.
Erythromycin 40 mg/kg/day/bid for 10 days
Outcome: Clinical success on day 9–11 by otorrhea at entryNot enough evidence to conclude
Otorrhea at entryNo Otorrhea at entryDiff (95% CI)
94.7% (36/38)94.6% (229/242)0.1%(−8, 8)
(C) Examiner
Comp #ComparisonArticlePatient PopulationInterventionFindingsConclusion
1Aqueous lidocaine drop vs. placeboBolt, 2008903–17 years
Tertiary children’s hospital emergency department in Australia
2% aqueous lidocaine 3 drops hourly for 1 day
vs.
Placebo
Outcome: Reduction by 50% in pain score on day 30Significantly more reduction in pain by parent if treated with lidocaine. Not enough evidence to conclude for doctor’s assessment
LidocainePlaceboDiff (95% CI)
By parent90% (28/31)63% (20/32)27%(6, 48)
By doctor84% (26/31)66% (21/32)18% (−3.4,39)
Diff (95% CI)6% (−11, 23)−3% (−26, 20)
(D) Pneumococcal vaccine
Comp #ComparisonArticlePatient PopulationInterventionFindingsConclusion
1Amox-clav vs. CefdinirBlock, 2004756 months–6years
Multi-centers in U.S.
Amoxicillin-clavulanate 45/6.4 mg/kg/day/bid for 10 days
vs.
Cefdinir 14 mg/kg/day/bid for 5 days
Outcome: Success at end-of-treatment visit (study days 7–9 for Cefdinir; study days 12–14 for Amox-clav) by PCV7Not enough evidence to conclude
Amox-clavCefdinirDiff (95% CI)
Had PCV782% (102/124)92% (115/125)−10%(−18, −2)
No PCV791% (62/68)80% (55/69)11% (−0.8, 23)
Diff (95% CI)−9% (−20, 1.5)12% (2.4, 22)

From: 3, Results

Cover of Management of Acute Otitis Media: Update
Management of Acute Otitis Media: Update.
Evidence Reports/Technology Assessments, No. 198.
Shekelle PG, Takata G, Newberry SJ, et al.

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