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To the Editor.—The meta-analysis by Ms Kozyrskyj and colleagues¹ provides clear and compelling evidence that the standard practice in the United States of 10 days of antibiotic therapy in the treatment of childhood acute otitis media (AOM) is not evidence-based medicine and is perhaps a dangerous clinical practice. This meta-analysis reinforces last year's extensive review by Pichichero and Cohen² that reached the same conclusions.

While it is encouraging to see scientifically sound studies proving that short-term antibiotic therapy is as effective as longer-duration therapy, clinicians should not stop focusing on the question of whether any antibiotic therapy is justified. If one were to hypothesize that antibiotic therapy is ineffective for AOM, then one would expect to find no significant differences between 10 days vs 5 days of therapy. If a control group is added for 0 days of antibiotic therapy, the result might be that 0 days is as . . . [Full Text of this Article]

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Assessing Diagnostic Accuracy and Tympanocentesis Skills in the Management of Otitis Media
Pichichero and Poole
Arch Pediatr Adolesc Med 2001;155:1137-1142.
ABSTRACT | FULL TEXT