Pediatric Recurrent Acute Otitis Media

Abstract

A computerized Ovid search of MEDLINE 1966-Junuary 2004 was performed. The terms “otitis media” and “antibiotics” were exploded and the resulting articles were cross-referenced, yielding 1947 trials. Given the known richnes sof the otitis media literature and the authority of higher levels of evidence, these artiles were then limited to randomized controlled trials (RCTs), resulting in 302 articles. These articles were then reviewed to identify those that met the following inclusion criteria: 1) patient population <18 years of age with documented recurrent acute otitis media (RAOM), 2) intervention with continuous amoxicillin or ampicillin prophylaxis versus placebo control, 3) outcome measured in terms of the number of episodes of acute otitis media (AOM). Articles in which noncontinuous antibiotic therapy was administered were excluded, as were articles that included patients on the basis of chronic middle ear effusion (MEE) alone. Also excluded were articles that were not placebo controlled, as well as those that enrolled children with nonrecurrent AOM (i.e, only one previous episode).