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Antibiotic therapy to prevent the development of asymptomatic middle ear effusion in children with acute otitismedia: a meta-analysis of individual patient data Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Ciprofloxacin hydrochloride & dexamethasone otic suspension - Otitismedia with otorrhea & otitis externa, acute Common Drug Review CEDAC Meeting – September 19, 2007 Page 1 of 2 Notice of CEDAC Final Recommendation – October 18, 2007 CEDAC FINAL RECOMMENDATION and REASONS for RECOMMENDATION CIPROFLOXACIN HCL and DEXAMETHASONE OTIC SUSPENSION (Ciprodex ® – Alcon Canada) Description: Ciprodex ® is a combination of ciprofloxacin HCl and dexamethasone that is indicated for the local treatment (...) of acute otitismedia with otorrhea through tympanostomy tubes in pediatric patients aged six months and older and for acute otitis externa in pediatric and adult patients aged one year and older. The review of ciprofloxacin HCl/dexamethasone (Ciprodex ® ) by the Common Drug Review was in response to a Request for Advice from the Advisory Committee on Pharmaceuticals which questioned if the CEDAC recommendation of January 26, 2005 that ciprofloxacin HCl/dexamethasone (Ciprodex ® ) not be listed, should
WITHDRAWN: Interventions for chronic suppurative otitismedia. Chronic suppurative otitismedia (CSOM) is a serious bacterial infection of the middle ear that can follow untreated acute otitis media.To assess the effects of different treatments for CSOM.We searched Medline from 1966 to 1996 and a bibliographic collection of the Hearing Impairment Research Group in Liverpool, UK. We handsearched two otolaryngology journals and contacted members of an international hearing network.Randomized
WITHDRAWN: Decongestants and antihistamines for acute otitismedia in children. Acute otitismedia (AOM) is a common and important source of morbidity in children, although most cases resolve spontaneously. While frequently recommended, decongestant and antihistamine therapy is of unclear benefit.To determine the efficacy of decongestant and antihistamine therapy in children with AOM on outcomes of AOM resolution, symptom resolution, medication side effects, and complications of AOM.We searched
Identification of children in the first four years of life for early treatment for otitismedia with effusion. Otitismedia with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. This condition has a point-prevalence of about 20% at the age of two years, a time of rapid language development. It is most often asymptomatic. Effective treatment exists for clearing effusions. Some have
Cost of ciprofloxacin/dexamethasone vs amoxicillin/clavulanic acid for the treatment of acute otitismedia in tympanostomy tube patients in the US Cost of ciprofloxacin/dexamethasone vs amoxicillin/clavulanic acid for the treatment of acute otitismedia in tympanostomy tube patients in the US Cost of ciprofloxacin/dexamethasone vs amoxicillin/clavulanic acid for the treatment of acute otitismedia in tympanostomy tube patients in the US Schmier J K, Waycaster C R, Wall G M Record Status (...) This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The study compared the cost-effectiveness of ciprofloxacin-dexamethasone ear drops with oral amoxicillin-clavulanic acid for the treatment of patients with acute otitismedia in the tympanostomy tube (AOMT
Cost-effectiveness analysis of treatment options for acute otitismedia Cost-effectiveness analysis of treatment options for acute otitismedia Cost-effectiveness analysis of treatment options for acute otitismedia Coco A S Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability (...) of the study and the conclusions drawn. Health technology The study compared four strategies for the treatment of acute otitismedia (AOM). The strategies were: watchful waiting, involving 72 hours of observation of possible symptom recession before administering amoxicillin; delayed prescription (DP), patients return to the office for a prescription of amoxicillin in the case that symptoms continue for 48 to 72 hours; routine antibiotic treatment with 5 days of amoxicillin; and routine antibiotic
Antibiotics for acute otitismedia: a meta-analysis with individual patient data. Individual trials to test effectiveness of antibiotics in children with acute otitismedia have been too small for valid subgroup analyses. We aimed to identify subgroups of children who would and would not benefit more than others from treatment with antibiotics.We did a meta-analysis of data from six randomised trials of the effects of antibiotics in children with acute otitismedia. Individual patient data from (...) 1643 children aged from 6 months to 12 years were validated and re-analysed. We defined the primary outcome as an extended course of acute otitismedia, consisting of pain, fever, or both at 3-7 days.Significant effect modifications were noted for otorrhoea, and for age and bilateral acute otitismedia. In children younger than 2 years of age with bilateral acute otitismedia, 55% of controls and 30% on antibiotics still had pain, fever, or both at 3-7 days, with a rate difference between
Antihistamines and/or decongestants for otitismedia with effusion (OME) in children. Otitismedia with effusion (OME) is common and may cause hearing loss with associated developmental delay. Treatment remains controversial. The effectiveness of antihistamines, decongestants and antihistamine/decongestant combinations in promoting the resolution of effusions has been assessed by randomized controlled trials.The objective of this review is to determine whether antihistamine, decongestant (...) searched by hand; pharmaceutical manufacturers of antihistamines and decongestants and first authors of included studies were contacted to identify other potentially relevant studies.Randomized controlled trials (RCTs) using antihistamines, decongestants or antihistamine/decongestant combinations as treatment for OME in children were selected. We excluded trials that randomized on the basis of acute otitismedia (AOM) even though OME was also studied in follow up.Data were extracted from the published
Antibiotics for the prevention of acute and chronic suppurative otitismedia in children. Acute otitismedia (AOM) is a common childhood illness. These middle ear infections may be frequent and painful. AOM may be associated with perforation of the tympanic membrane and can progress to chronic suppurative otitismedia (CSOM).To determine the effectiveness of long-term antibiotics (for longer than six weeks) in preventing any AOM, AOM with perforation and CSOM.We searched the Cochrane Central (...) to otitismedia. The majority of studies were high quality and most (15 studies) reported data for our primary outcomes. None reported AOM with perforation or CSOM. Long-term antibiotics reduced any episode of AOM (13 studies, 1358 children, risk ratio (RR) 0.62, 95% CI 0.52 to 0.75; random-effects model) and number of episodes of AOM (12 studies, 1112 children, incidence rate ratio (IRR) 0.48, 95% CI 0.37 to 0.62; random-effects model). Approximately five children would need to be treated long term
Autoinflation for hearing loss associated with otitismedia with effusion. Otitismedia with effusion (OME) or 'glue ear' is an accumulation of fluid in the middle ear, in the absence of acute inflammation or infection. It is the commonest cause of acquired hearing loss in childhood and the usual reason for insertion of 'grommets'. Potential treatments include decongestants, mucolytics, steroids, antihistamines and antibiotics. Autoinflation devices have been proposed as a simple mechanical (...) means of improving 'glue ear'.To determine the effects of autoinflation in adults and children with otitismedia with effusion.We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, CENTRAL (The Cochrane Library Issue 1, 2006), MEDLINE (1951 to 2006), EMBASE (1974 to 2006) and twelve other databases, using the Cochrane Ear, Nose and Throat Disorders Group search strategy.We selected randomised controlled trials that compared any form of autoinflation to no autoinflation
Oral or topical nasal steroids for hearing loss associated with otitismedia with effusion in children. Otitismedia with effusion (OME) is common and may cause hearing loss with associated developmental delay. Treatment remains controversial.To examine evidence for or against treating children with hearing loss associated with OME with systemic or topical intranasal steroids.We searched the Cochrane Ear, Nose and Throat Disorders Group Specialised Register, the Cochrane Central Register
Topical analgesia for acute otitismedia. Acute otitismedia (AOM) is a spontaneously remitting disease for which pain is the most distressing symptom. Antibiotics are now known to have less benefit than previously assumed.To assess the effectiveness of topical analgesia for AOM.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2006), MEDLINE (1966 to May Week 3 2006), EMBASE (1990 to December 2005) and LILACS (1982 to September 2005
Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitismedia. Chronic otitismedia (OM) is a common pediatric infectious disease. Previous studies demonstrating that metabolically active bacteria exist in culture-negative pediatric middle-ear effusions and that experimental infection with Haemophilus influenzae in the chinchilla model of otitismedia results in the formation of adherent mucosal biofilms suggest that chronic OM may result from a mucosal (...) biofilm infection.To test the hypothesis that chronic OM in humans is biofilm-related.Middle-ear mucosa (MEM) biopsy specimens were obtained from 26 children (mean age, 2.5 [range, 0.5-14] years) undergoing tympanostomy tube placement for treatment of otitismedia with effusion (OME) and recurrent OM and were analyzed using microbiological culture, polymerase chain reaction (PCR)-based diagnostics, direct microscopic examination, fluorescence in situ hybridization, and immunostaining. Uninfected
Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitismedia caused by both Streptococcus pneumoniae and non-typable Haemophilus influenzae: a randomised double-blind efficacy study. Acute otitismedia is one of the most commonly-diagnosed childhood infections. This study assessed the efficacy of a novel vaccine that contained polysaccharides from 11 different Streptococcus pneumoniae serotypes each conjugated to Haemophilus influenzae-derived protein D (...) in prevention of acute otitismedia.4968 infants were randomly assigned to receive either pneumococcal protein D conjugate or hepatitis A vaccine at the ages of 3, 4, 5, and 12-15 months and were followed-up until the end of the second year of life. Middle-ear fluid was obtained for bacteriological culture and serotyping in children who presented with abnormal tympanic membrane or presence of middle-ear effusion, plus two predefined clinical symptoms. The primary endpoint was protective efficacy against
Wait-and-see prescription for the treatment of acute otitismedia: a randomized controlled trial. Acute otitismedia (AOM) is the most common diagnosis for which antibiotics are prescribed for children. Previous trials that have evaluated a "wait-and-see prescription" (WASP) for antibiotics, with which parents are asked not to fill the prescription unless the child either is not better or is worse in 48 hours, have excluded children with severe AOM. None of these trials were conducted
Antibiotics for acute otitismedia: a meta-analysis with individual patient data Antibiotics for acute otitismedia: a meta-analysis with individual patient data Antibiotics for acute otitismedia: a meta-analysis with individual patient data Rovers M M, Glasziou P, Appelman C L, Burke P, McCormick D P, Damoiseaux R A, Gaboury I, Little P, Hoes A W CRD summary The review aimed to identify subgroups of children with acute otitismedia (AOM) who would benefit from treatment with antibiotics (...) . The authors concluded that antibiotics are beneficial in children younger than two years who have bilateral AOM, or AOM and otorrhoea, but an observational policy seems justified for most others. The first conclusion appears reliable, but the results do not directly support the second conclusion. Authors' objectives To identify subgroups of children with acute otitismedia (AOM) who would and would not benefit from treatment with antibiotics. Searching PubMed, EMBASE, the Cochrane Library and proceedings
Cost-effectiveness of implementing national guidelines in the treatment of acute otitismedia in children Cost-effectiveness of implementing national guidelines in the treatment of acute otitismedia in children Cost-effectiveness of implementing national guidelines in the treatment of acute otitismedia in children Koskinen H, Rautakorpi U M, Sintonen H, Honkanen P, Huikko S, Huovinen P, Klaukka T, Palva E, Roine R P, Sarkkinen H, Varonen H, Makela M Record Status This is a critical abstract (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The use of national guidelines in the treatment of acute otitismedia (AOM) in children was investigated. These guidelines were part of a programme introducing guidelines for six common infections. The patients or the caregiver filled