TY - JOUR T1 - Antibiotics administered for acute otitis media have modest benefits and adverse effects JF - Evidence Based Medicine JO - Evid Based Med SP - 181 LP - 181 DO - 10.1136/ebmed-2016-110398 VL - 21 IS - 5 AU - Jennifer J Shin Y1 - 2016/10/01 UR - http://ebm.bmj.com/content/21/5/181.abstract N2 - Commentary on: Venekamp RP, Sanders SL, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2015;(6):CD000219.Acute otitis media (AOM) is a highly prevalent condition, with 50–85% of children affected by 3 years of age.1 Cases may spontaneously remit, but may also culminate in pain, fever, tympanic membrane perforation or mastoiditis. Antibiotic usage varies worldwide, and these data inform this decision by assessing the impact of: (1) antibiotics compared to placebo, (2) immediate antibiotics compared to expectant observation and (3) potential effect modifiers.This systematic review included randomised controlled trials (RCTs) focused on patient-relevant outcomes. Primary outcomes were the proportion of children with: (1) pain at 1, 2–3, 4–7 and 10–14 days, and (2) adverse effects (vomiting/diarrhoea/rash). Secondary outcomes included abnormal tympanometry, tympanic membrane perforation, contralateral AOM, complications of AOM and long-term healthcare utilisation. Searches were undertaken in a litany of databases, and independent extraction was performed. Study quality was assessed according to possible allocation/performance/attrition/other biases; a grading of recommendation, … ER -