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Comparative Efficacy and Optimal Duration of First-line Antibiotic Regimens for Acute Otitis Media in Children and Adolescents: a Systematic Review and Network Meta-analysis of 89 Randomized Clinical Trials by Min Seo Kim; Jae Han Kim; Seohyun Ryu; Seung Won Lee; Dong Keon Yon; Eunyoung Kim; Ai Koyanagi; Elena Dragioti; Jae Il Shin; Lee Smith is a Medicine article available to read on EtoBox.

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Introduction Antibiotic use for acute otitis media (AOM) is one of the major sources of antimicrobial resistance. However, the effective minimal antibiotic duration for AOM remains unclear. Moreover, guidelines often recommend broad ranges (5-10 days) of antibiotic use, yet the clinical impact of such a wide window has not been assessed. Methods We systematically searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library from database inception to 6 October 2021. Network meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children (PROSPERO CRD42020196107). Results For amoxicillin and amoxicillin-clavulanate, 7-day regimens were noninferior to 10-day regimens in clinical responses [amoxicillin: risk ratio (RR) 0.919 (95% CI 0.820-1.031), amoxicillin-clavulanate: RR 1.108 (0.957-1.282)], except for ≤ 2 years. For the third-generation cephalosporins, 7-day and 10-day regimens had similar clinical responses compared to placebo , 10-day: RR 1.238 (1.125-1.362) compared to placebo]. However, 5-day regimens of amoxicillin-clavulanate and third-generation cephalosporins were inferior to 10-day regimens. Compared to a

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Author

Min Seo Kim; Jae Han Kim; Seohyun Ryu; Seung Won Lee; Dong Keon Yon; Eunyoung Kim; Ai Koyanagi; Elena Dragioti; Jae Il Shin; Lee Smith

Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)