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Comparative efficac...
Comparative efficacy and optimal duration of first-line antibiotic regimens for acute otitis media in children and adolescents: a systematic review and network meta-analysis of 89 randomized clinical trials
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- Kim, Min Seo (författare)
- Sungkyunkwan Univ, South Korea
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- Kim, Jae Han (författare)
- Yonsei Univ, South Korea
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- Ryu, Seohyun (författare)
- Yonsei Univ, South Korea
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- Lee, Seung Won (författare)
- Sungkyunkwan Univ, South Korea
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- Yon, Dong Keon (författare)
- Kyung Hee Univ, South Korea
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- Kim, Eunyoung (författare)
- Chung Ang Univ, South Korea
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- Koyanagi, Ai (författare)
- Univ Barcelona, Spain; ICREA, Spain
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- Dragioti, Elena (författare)
- Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum,Univ Ioannina, Greece
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- Shin, Jae (författare)
- Yonsei Univ, South Korea
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- Smith, Lee (författare)
- Anglia Ruskin Univ, England
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: World Journal of Pediatrics. - : ZHEJIANG UNIV PRESS. - 1708-8569 .- 1867-0687.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- IntroductionAntibiotic use for acute otitis media (AOM) is one of the major sources of antimicrobial resistance. However, the effective minimal antibiotic duration for AOM remains unclear. Moreover, guidelines often recommend broad ranges (5-10 days) of antibiotic use, yet the clinical impact of such a wide window has not been assessed.MethodsWe systematically searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library from database inception to 6 October 2021. Network meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children (PROSPERO CRD42020196107).ResultsFor amoxicillin and amoxicillin-clavulanate, 7-day regimens were noninferior to 10-day regimens in clinical responses [amoxicillin: risk ratio (RR) 0.919 (95% CI 0.820-1.031), amoxicillin-clavulanate: RR 1.108 (0.957-1.282)], except for <= 2 years. For the third-generation cephalosporins, 7-day and 10-day regimens had similar clinical responses compared to placebo [7-day: RR 1.420 (1.190-1.694), 10-day: RR 1.238 (1.125-1.362) compared to placebo]. However, 5-day regimens of amoxicillin-clavulanate and third-generation cephalosporins were inferior to 10-day regimens. Compared to amoxicillin, a shorter treatment duration was tolerable with amoxicillin-clavulanate.ConclusionsOur findings indicated that 10 days of antibiotic use may be unnecessarily long, while the treatment duration should be longer than 5 days. Otherwise, 5-day regimens would be sufficient for a modest treatment goal. Our findings revealed that the current wide range of recommended antibiotic durations may have influenced the clinical outcome of AOM, and a narrower antibiotic duration window should be re-established.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oto-rhino-laryngologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Otorhinolaryngology (hsv//eng)
Nyckelord
- Amoxicillin-potassium; Amoxicillin; Antibacterial agents; Cephalosporins; Duration of therapy
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Kim, Min Seo
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Kim, Jae Han
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Ryu, Seohyun
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Lee, Seung Won
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Yon, Dong Keon
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Kim, Eunyoung
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visa fler...
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Koyanagi, Ai
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Dragioti, Elena
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Shin, Jae
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Smith, Lee
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Oto rhino laryng ...
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World Journal of ...
- Av lärosätet
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Linköpings universitet