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Richard M. Rosenfeld, MD, MPH
SUNY Health Science Center at Brooklyn (NY) and Long Island (NY) College Hospital

JAMA. 1993;270(4):449-450.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—On reading a recent Commentary by Mandel et al,¹I was struck by the absence of any reference to the only published meta-analysis² addressing the efficacy of antimicrobials for otitis media with effusion (OME) in children. In their overview of 1325 children from 10 randomized clinical trials, Rosenfeld and Post² found a 22.8% treatment advantage (95% CI, 10.5% to 35.1%) for antimicrobials over placebo or no drug. What effect—if any—does "The Cantekin Affair"³ have on the interpretation and validity of this finding?

The Cantekin affair concerns one of the 10 studies in the meta-analysis, and relates primarily to the choice of OME outcome measure: algorithm vs tympanometry. Mandel et al⁴ initially reported a 14.6% treatment advantage for amoxicillin (95% CI, 5.8% to 23.5%; P=.002) based on an otoscopic-tympanometric algorithm; this outcome measure was therefore used in the meta-analysis. A dissenting version . . . [Full Text PDF of this Article]

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