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The risks of prolonged acute otitis media in children who are not initially treated with antibiotics are two times higher if the patients are aged younger than 2 years and have acute bilateral infection, compared with older children who have unilateral infection, according to a meta-analysis.
“Clinicians can use these features … to inform parents more explicitly about the expected course of their child's AOM [acute otitis media] and to explain which features should prompt parents to contact their clinician for reexamination of the child,” wrote Maroeska M. Rovers, Ph.D., of the Julius Center for Health Sciences and Primary Care, and Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands, and colleagues (Pediatrics 2007;119; 579–85).
The meta-analysis included six randomized, controlled trials of children aged 6 months to 12 years with AOM who were randomized to antibiotic therapy or observation (either placebo or no treatment). Only the 824 patients in the observation arms were included in the analysis. The primary outcome was a prolonged infection defined as fever and/or pain at 3–7 days, and the predictors analyzed were age, gender, season, having been breast-fed or not, presence or absence of recurrent AOM, and baseline symptoms of fever, pain, bilateral AOM, otorrhea, and appearance of tympanic membrane (bulging, redness, perforation).
Of the 824 children, 303 (37%) had fever and/or pain at 3–7 days.
The absolute risks of pain and/or fever at follow-up were highest for children aged under 2 years with bilateral infection (55%) and lowest for those aged 2 years or older with unilateral infection (25%).
The risks of prolonged acute otitis media in children who are not initially treated with antibiotics are two times higher if the patients are aged younger than 2 years and have acute bilateral infection, compared with older children who have unilateral infection, according to a meta-analysis.
“Clinicians can use these features … to inform parents more explicitly about the expected course of their child's AOM [acute otitis media] and to explain which features should prompt parents to contact their clinician for reexamination of the child,” wrote Maroeska M. Rovers, Ph.D., of the Julius Center for Health Sciences and Primary Care, and Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands, and colleagues (Pediatrics 2007;119; 579–85).
The meta-analysis included six randomized, controlled trials of children aged 6 months to 12 years with AOM who were randomized to antibiotic therapy or observation (either placebo or no treatment). Only the 824 patients in the observation arms were included in the analysis. The primary outcome was a prolonged infection defined as fever and/or pain at 3–7 days, and the predictors analyzed were age, gender, season, having been breast-fed or not, presence or absence of recurrent AOM, and baseline symptoms of fever, pain, bilateral AOM, otorrhea, and appearance of tympanic membrane (bulging, redness, perforation).
Of the 824 children, 303 (37%) had fever and/or pain at 3–7 days.
The absolute risks of pain and/or fever at follow-up were highest for children aged under 2 years with bilateral infection (55%) and lowest for those aged 2 years or older with unilateral infection (25%).
The risks of prolonged acute otitis media in children who are not initially treated with antibiotics are two times higher if the patients are aged younger than 2 years and have acute bilateral infection, compared with older children who have unilateral infection, according to a meta-analysis.
“Clinicians can use these features … to inform parents more explicitly about the expected course of their child's AOM [acute otitis media] and to explain which features should prompt parents to contact their clinician for reexamination of the child,” wrote Maroeska M. Rovers, Ph.D., of the Julius Center for Health Sciences and Primary Care, and Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands, and colleagues (Pediatrics 2007;119; 579–85).
The meta-analysis included six randomized, controlled trials of children aged 6 months to 12 years with AOM who were randomized to antibiotic therapy or observation (either placebo or no treatment). Only the 824 patients in the observation arms were included in the analysis. The primary outcome was a prolonged infection defined as fever and/or pain at 3–7 days, and the predictors analyzed were age, gender, season, having been breast-fed or not, presence or absence of recurrent AOM, and baseline symptoms of fever, pain, bilateral AOM, otorrhea, and appearance of tympanic membrane (bulging, redness, perforation).
Of the 824 children, 303 (37%) had fever and/or pain at 3–7 days.
The absolute risks of pain and/or fever at follow-up were highest for children aged under 2 years with bilateral infection (55%) and lowest for those aged 2 years or older with unilateral infection (25%).