| Efficacy of short course (<4 days) of antibiotics for treatment of acute otitis media in children: a systematic review of randomized controlled trials. | |
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MedLine Citation:
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PMID: 19736367 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the efficacy of a short course of antibiotics (<4 days) in comparison to a longer course (>4 days) for the treatment of acute otitis media in children. DATA SOURCES: Electronic databases, hand search of reviews, bibliographies of books, abstracts and proceedings of international conferences. REVIEW METHODS: Randomized controlled trials of the empiric treatment of acute otitis media comparing antibiotic regimens of <4 days versus > 4 days in children between four weeks to eighteen years of age were included. The trials were grouped by pharmacokinetic behavior of short-course antibiotics into short-acting antibiotics, parenteral ceftriaxone, and long-acting azithromycin. RESULTS: We reviewed 35 trials, which provided 38 analytic components. Overall, there was no evidence of an increased risk of treatment failure until one month with a short-course of antibiotics (RR=1.06, 95% CI 0.95 to 1.17, P=0.298). Use of short-acting oral antibiotic in short-course was associated with a significantly increased risk of treatment failure (RR=2.27, 95% CI: 1.04 to 4.99). There was a slightly increased risk of treatment failure with parenteral ceftriaxone (RR=1.13, 95% CI 0.99 to 1.30). The risk of adverse effects was significantly lower with short-course regimens (RR=0.58, 95% CI: 0.48 to 0.70). CONCLUSION: There is no evidence of an increased risk of treatment failure with short course of antibiotics for acute otitis media. Among the short course regimens, azithromycin use was associated with a lower risk of treatment failure while short acting oral antibiotics and parenteral ceftriaxone may be associated with a higher risk of treatment failure. |
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Authors:
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Anjana Gulani; H P S Sachdev; Shamim A Qazi |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review Date: 2009-09-03 |
Journal Detail:
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Title: Indian pediatrics Volume: 47 ISSN: 0974-7559 ISO Abbreviation: Indian Pediatr Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-02-08 Completed Date: 2010-05-10 Revised Date: 2010-11-15 |
Medline Journal Info:
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Nlm Unique ID: 2985062R Medline TA: Indian Pediatr Country: India |
Other Details:
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Languages: eng Pagination: 74-87 Citation Subset: IM |
Affiliation:
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Department of Pediatrics and Clinical Epidemology, Sitaram Bhartia Institute of Science and Research, Qutab Institutional Area, New Delhi 110 016, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Anti-Bacterial Agents / administration & dosage* Azithromycin / administration & dosage Ceftriaxone / administration & dosage Child Child, Preschool Drug Administration Schedule Humans Infant Otitis Media / drug therapy* Randomized Controlled Trials as Topic Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 73384-59-5/Ceftriaxone; 83905-01-5/Azithromycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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