2011年1月13日 星期四

中耳炎還是用抗生素比較好〔?〕

What is the most effective treatment for acute otitis media?
Amoxicillin–clavulanate has been shown to be the most effective treatment for acute otitis media.

As compared to placebo treatment, what were the benefits of antibiotic treatment for children 6 to 23 months of age with acute otitis media in this clinical trial?
Children who were treated with amoxicillin–clavulanate, as compared with those who received placebo, had consistently more favorable short-term outcomes, including a sustained symptomatic response, an absence of otoscopic evidence of persistent middle-ear infection, and a reduced rate of residual middle-ear effusion.

As compared to placebo treatment, was speed of resolution different for children who received antibiotic treatment in this study?
Yes, among the children who received amoxicillin–clavulanate, 35% had initial resolution of symptoms by day 2, 61% by day 4, and 80% by day 7; among children who received placebo, 28% had initial resolution of symptoms by day 2, 54% by day 4, and 74% by day 7.

As compared to placebo-treated children, what adverse effects were significantly more common among children with acute otitis media who received antibiotic treatment?
Dermatitis in the diaper area and protocol-defined diarrhea occurred commonly, and often together, among children receiving antimicrobial agents. Both protocol-defined diarrhea and diaper area dermatitis occurred significantly more frequently among children who received amoxicillin–clavulanate than those that received placebo.

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NEJM

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