Damoiseaux Roger A J M, Rovers Maroeska M
General Practice de Hof van Blom, Hattem, The Netherlands.
BMJ Clin Evid. 2011 May 10;2011:0301.
In the UK, about 30% of children under 3 years of age visit their GP each year with acute otitis media (AOM), and 97% of these receive antibiotics. In the US, AOM is the most common reason for outpatient antibiotic treatment. Without antibiotics, AOM resolves within 24 hours in about 60% of children, and within 3 days in about 80% of children.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for AOM in children; and what are the effects of interventions to prevent recurrence? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 29 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics, delayed antibiotics, immediate antibiotics, long-term antibiotic prophylaxis, longer courses of antibiotics, myringotomy, pneumococcal vaccination, tympanostomy with ventilation tubes, xylitol syrup or gum, and influenza vaccination.
在英国，每年约30%的3岁以下儿童因急性中耳炎（AOM）就诊于全科医生，其中97%接受了抗生素治疗。在美国，AOM是门诊抗生素治疗的最常见原因。在不使用抗生素的情况下，约60%的儿童AOM在24小时内痊愈，约80%的儿童在3天内痊愈。
我们进行了一项系统评价，旨在回答以下临床问题：儿童AOM的治疗效果如何；预防复发的干预措施效果如何？我们检索了：截至2010年9月的Medline、Embase、Cochrane图书馆及其他重要数据库（《临床证据》综述会定期更新；请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品与保健品监管局（MHRA）等相关组织的危害警示。
我们发现29项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中，我们呈现了以下干预措施的有效性和安全性相关信息：镇痛药、抗生素、延迟使用抗生素、立即使用抗生素、长期抗生素预防、更长疗程的抗生素、鼓膜切开术、肺炎球菌疫苗接种、带通气管的鼓膜造孔术、木糖醇糖浆或口香糖以及流感疫苗接种。
