When to give antibiotics in otitis media

Children with otitis media with a raised temperature and vomiting are more likely to benefit from immediate treatment with antibiotics than children with no fever or vomiting. Little and colleagues (p 22) used data from a randomised controlled trial cohort of antibiotic prescribing strategies for otitis media and identified predictors of poor outcome. They then assessed benefit from treatment in these subgroups. Children who did not have raised temperature and vomiting were unlikely to have poor outcome and unlikely to benefit from immediate antibiotics.

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Relevant Article

Predictors of poor outcome and benefits from antibiotics in children with acute otitis media: pragmatic randomised trial • Commentary: research directions for treatment for acute otitis media

Paul Little, Clare Gould, Michael Moore, Greg Warner, Joan Dunleavey, Ian Williamson, Chris Del Mar, and Jenny Doust
BMJ 2002 325: 22. [Abstract] [Full Text] [PDF]