Compared to placebo, long-term antibiotics resolve otitis media with effusion (OME) and prevent acute otitis media with perforation (AOMwiP) in a high-risk population: A randomized controlled trial

dc.contributor.authorLeach, Amanda Jane
dc.contributor.authorMatthews, John D
dc.contributor.authorMorris, Peter Stanley
dc.date.accessioned2010-07-27T06:21:08Z
dc.date.available2010-07-27T06:21:08Z
dc.date.issued2008en_US
dc.description© 2008 Leach et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en
dc.description.abstractBackground : For children at high risk of chronic suppurative otitis media (CSOM), strategies to prevent acute otitis media with perforation (AOMwiP) may reduce progression to CSOM. Methods : In a double blind study in northern Australia, 103 Aboriginal infants with first detection of OME were randomised to receive either amoxicillin (50 mg/kg/d BD) or placebo for 24 weeks, or until bilateral aerated middle ears were diagnosed at two successive monthly examinations (success). Standardised clinical assessments and international standards for microbiology were used. Results : Five of 52 infants in the amoxicillin group and none of 51 infants in the placebo group achieved success at the end of therapy (Risk Difference = 9.6% [95% confidence interval 1.6,17.6]). Amoxicillin significantly reduced the proportion of children with i) perforation at the end of therapy (27% to 12% RD = -16% [-31,-1]), ii) recurrent perforation during therapy (18% to 4% RD = -14% [-25,-2]), and iii) reduced the proportion of examinations with a diagnosis of perforation during therapy (20% to 8% adjusted risk ratio 0.36 [0.15,0.83] p = 0.017). During therapy, the proportion of examinations with penicillin non-susceptible (MIC > 0.1 microg/ml) pneumococci was not significantly different between the amoxicillin group (34%) and the placebo group (40%). Beta-lactamase positive non-capsular H. influenzae (NCHi) were uncommon during therapy but more frequent in the amoxicillin group (10%) than placebo (5%). Conclusion : Aboriginal infants receiving continuous amoxicillin had more normal ears, fewer perforations, and less pneumococcal carriage. There was no statistically significant increase in resistant pneumococci or NCHi in amoxicillin children compared to placebo children who received regular paediatric care and antibiotic treatment for symptomatic illnesses.en
dc.identifier.citationLeach, A.J., Morris, P.S., & Matthews, J.D., 2008. Compared to placebo, long-term antibiotics resolve otitis media with effusion (OME) and prevent acute otitis media with perforation (AOMwiP) in a high-risk population: A randomized controlled trial. BMC Paediatrics, 8(23).en
dc.identifier.doihttps://doi.org/10.1186/1471-2431-8-23
dc.identifier.issn1471-2431
dc.identifier.rmid2006010533
dc.identifier.urihttp://hdl.handle.net/2328/11283
dc.language.isoen
dc.oaire.license.condition.licenseCC-BY
dc.rights© 2008 Leach et al; licensee BioMed Central Ltd.en
dc.rights.holderLeach et al; licensee BioMed Central Ltd.en
dc.subject.forgroup1103 Clinical Sciencesen
dc.subject.forgroup1114 Paediatrics and Reproductive Medicineen
dc.titleCompared to placebo, long-term antibiotics resolve otitis media with effusion (OME) and prevent acute otitis media with perforation (AOMwiP) in a high-risk population: A randomized controlled trialen
dc.typeArticleen
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