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Acute otitis media (AOM) is a common infection of childhood often immediately treated with antibiotics in the USA,1 while delayed prescribing is common in the UK.2 It is unclear how recent conjugate vaccines have affected microbial epidemiology and whether antibiotic efficacy in AOM has changed over the past decade.
Coker and colleagues systematically searched the PubMed, Cochrane and Web of Science databases for manuscripts published from 1999 through 2010 for studies of children with AOM (aged 4 months to 18 years) that reported diagnostic accuracy, treatment outcomes or the effect of heptavalent pneumococcal conjugate vaccine (PCV-7) upon microbial epidemiology. This search supplemented to authors published systematic review of the literature from 1966 through 1999.3 Two investigators independently reviewed the identified articles' titles and abstracts, initially including all manuscripts describing results of randomised controlled trials (RCTs), controlled clinical trials, systematic reviews or observational …
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