METAANALYSIS OF ANTIMICROBIAL PROPHYLAXIS FOR RECURRENT ACUTE OTITIS-MEDIA

Eight randomised controlled trials of the chemoprophylaxis of recurrent otitis media in children made over the past 15 years were reviewed as part of a training project by a group of paediatric practitioners. A total of 420 children were treated using five drugs. Comparisons made using odds ratios with confidence intervals provided significant evidence of prevention of recurrence with all agents. Deficiencies of quality apparent in some of the studies did not diminish the significance of the findings. A large enough collaborative trial is needed with careful long-term follow-up to confirm that chemoprophylaxis not only prevents acute otitis media but also reduces the frequency of possible sequelae (otitis media with effusion associated with learning disabilities and behavioural problems). Future findings could help better define the whole management of this challenging and controversial paediatric condition.