Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse

Translated title of the contribution: Which children with otitis media acuta benefit from treatment with antibiotics? An individual patient data meta-analysis

Maroeska Rovers, Paul Glasziou, Cees Appelman, Peter Burke, David McCormick, Roger Damoiseaux, Isabelle Gaboury, Paul Little, Arno Hoes

Research output: Contribution to journalArticle

Abstract

Background: At present it is not known which subgroups of children with otitis media acuta (AOM) derive benefit from antibiotics and which do not. Methods: In an individual patient data meta-analysis on six randomised trials, including 1643 children aged 6 months to 12 years with AOM, we performed subgroup analyses to identify children who might benefit more than others from treatment with antibiotics. The primary outcome was a prolonged course of AOM, which was defined as having either residual pain or fever at 3-7 days. Results: In children younger than 2 years of age with bilateral AOM, 55% in the control group and 30% in the antibiotics group still had pain and/or fever at 3-7 days: a rate difference (RD) of -25% (95% CI -36 - -14%, NNT 4). In children aged 2 years or older with unilateral AOM these percentages were 26% and 19% (RD -7%, 95% CI -14-0%, NNT 15). For age alone no differences were found. In children with and without otorrhoea the RD and NNT were -36% (95% CI -53 - -19%) and 3, and -14% (95% CI -23% - -5%) and 8. Discussion: Antibiotics appear to be more beneficial in children younger than 2 years of age with bilateral AOM, and in children with AOM and otorrhoea. For most other children with mild disease an observational policy seems justified. The Dutch AOM guideline has been changed to match these findings.

Original languageDutch
Pages (from-to)650-655
Number of pages6
JournalHuisarts en Wetenschap
Volume49
Issue number13
StatePublished - Dec 2006
Externally publishedYes

Fingerprint

Otitis Media
Meta-Analysis
Anti-Bacterial Agents
Therapeutics
Fever
Pain
Guidelines
Control Groups

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Rovers, M., Glasziou, P., Appelman, C., Burke, P., McCormick, D., Damoiseaux, R., ... Hoes, A. (2006). Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse. Huisarts en Wetenschap, 49(13), 650-655.

Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse. / Rovers, Maroeska; Glasziou, Paul; Appelman, Cees; Burke, Peter; McCormick, David; Damoiseaux, Roger; Gaboury, Isabelle; Little, Paul; Hoes, Arno.

In: Huisarts en Wetenschap, Vol. 49, No. 13, 12.2006, p. 650-655.

Research output: Contribution to journalArticle

Rovers, M, Glasziou, P, Appelman, C, Burke, P, McCormick, D, Damoiseaux, R, Gaboury, I, Little, P & Hoes, A 2006, 'Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse', Huisarts en Wetenschap, vol. 49, no. 13, pp. 650-655.
Rovers M, Glasziou P, Appelman C, Burke P, McCormick D, Damoiseaux R et al. Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse. Huisarts en Wetenschap. 2006 Dec;49(13):650-655.
Rovers, Maroeska ; Glasziou, Paul ; Appelman, Cees ; Burke, Peter ; McCormick, David ; Damoiseaux, Roger ; Gaboury, Isabelle ; Little, Paul ; Hoes, Arno. / Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse. In: Huisarts en Wetenschap. 2006 ; Vol. 49, No. 13. pp. 650-655.
@article{35be9155d4ca4b0d973baede35be49cb,
title = "Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele pati{\"e}nten data meta-analyse",
abstract = "Background: At present it is not known which subgroups of children with otitis media acuta (AOM) derive benefit from antibiotics and which do not. Methods: In an individual patient data meta-analysis on six randomised trials, including 1643 children aged 6 months to 12 years with AOM, we performed subgroup analyses to identify children who might benefit more than others from treatment with antibiotics. The primary outcome was a prolonged course of AOM, which was defined as having either residual pain or fever at 3-7 days. Results: In children younger than 2 years of age with bilateral AOM, 55{\%} in the control group and 30{\%} in the antibiotics group still had pain and/or fever at 3-7 days: a rate difference (RD) of -25{\%} (95{\%} CI -36 - -14{\%}, NNT 4). In children aged 2 years or older with unilateral AOM these percentages were 26{\%} and 19{\%} (RD -7{\%}, 95{\%} CI -14-0{\%}, NNT 15). For age alone no differences were found. In children with and without otorrhoea the RD and NNT were -36{\%} (95{\%} CI -53 - -19{\%}) and 3, and -14{\%} (95{\%} CI -23{\%} - -5{\%}) and 8. Discussion: Antibiotics appear to be more beneficial in children younger than 2 years of age with bilateral AOM, and in children with AOM and otorrhoea. For most other children with mild disease an observational policy seems justified. The Dutch AOM guideline has been changed to match these findings.",
author = "Maroeska Rovers and Paul Glasziou and Cees Appelman and Peter Burke and David McCormick and Roger Damoiseaux and Isabelle Gaboury and Paul Little and Arno Hoes",
year = "2006",
month = "12",
language = "Dutch",
volume = "49",
pages = "650--655",
journal = "Huisarts en Wetenschap",
issn = "0018-7070",
publisher = "Bohn Stafleu van Loghum",
number = "13",

}

TY - JOUR

T1 - Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica? Een individuele patiënten data meta-analyse

AU - Rovers, Maroeska

AU - Glasziou, Paul

AU - Appelman, Cees

AU - Burke, Peter

AU - McCormick, David

AU - Damoiseaux, Roger

AU - Gaboury, Isabelle

AU - Little, Paul

AU - Hoes, Arno

PY - 2006/12

Y1 - 2006/12

N2 - Background: At present it is not known which subgroups of children with otitis media acuta (AOM) derive benefit from antibiotics and which do not. Methods: In an individual patient data meta-analysis on six randomised trials, including 1643 children aged 6 months to 12 years with AOM, we performed subgroup analyses to identify children who might benefit more than others from treatment with antibiotics. The primary outcome was a prolonged course of AOM, which was defined as having either residual pain or fever at 3-7 days. Results: In children younger than 2 years of age with bilateral AOM, 55% in the control group and 30% in the antibiotics group still had pain and/or fever at 3-7 days: a rate difference (RD) of -25% (95% CI -36 - -14%, NNT 4). In children aged 2 years or older with unilateral AOM these percentages were 26% and 19% (RD -7%, 95% CI -14-0%, NNT 15). For age alone no differences were found. In children with and without otorrhoea the RD and NNT were -36% (95% CI -53 - -19%) and 3, and -14% (95% CI -23% - -5%) and 8. Discussion: Antibiotics appear to be more beneficial in children younger than 2 years of age with bilateral AOM, and in children with AOM and otorrhoea. For most other children with mild disease an observational policy seems justified. The Dutch AOM guideline has been changed to match these findings.

AB - Background: At present it is not known which subgroups of children with otitis media acuta (AOM) derive benefit from antibiotics and which do not. Methods: In an individual patient data meta-analysis on six randomised trials, including 1643 children aged 6 months to 12 years with AOM, we performed subgroup analyses to identify children who might benefit more than others from treatment with antibiotics. The primary outcome was a prolonged course of AOM, which was defined as having either residual pain or fever at 3-7 days. Results: In children younger than 2 years of age with bilateral AOM, 55% in the control group and 30% in the antibiotics group still had pain and/or fever at 3-7 days: a rate difference (RD) of -25% (95% CI -36 - -14%, NNT 4). In children aged 2 years or older with unilateral AOM these percentages were 26% and 19% (RD -7%, 95% CI -14-0%, NNT 15). For age alone no differences were found. In children with and without otorrhoea the RD and NNT were -36% (95% CI -53 - -19%) and 3, and -14% (95% CI -23% - -5%) and 8. Discussion: Antibiotics appear to be more beneficial in children younger than 2 years of age with bilateral AOM, and in children with AOM and otorrhoea. For most other children with mild disease an observational policy seems justified. The Dutch AOM guideline has been changed to match these findings.

UR - http://www.scopus.com/inward/record.url?scp=33846449948&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846449948&partnerID=8YFLogxK

M3 - Article

VL - 49

SP - 650

EP - 655

JO - Huisarts en Wetenschap

JF - Huisarts en Wetenschap

SN - 0018-7070

IS - 13

ER -