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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 clinicaltrials

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World Journal of Pediatrics 2024年第3期20卷 219-229页

作者： Min Seo Kim Jae Han Kim seohyun ryu Seung Won Lee Dong Keon Yon Eunyoung Kim Ai Koyanagi Elena Dragioti Jae Il Shin Lee Smith Samsung Advanced Institute forHealth Sciences&Technology(SAIHST) Samsung Medical CenterSungkyunkwan UniversitySeoulRepublic of Korea Yonsei University Collegeof Medicine SeoulRepublicof Korea Department of Precision Medicine Sungkyunkwan University School of MedicineSuwonRepublic of Korea Center for Digital Health Medical Science Research InstituteKyung Hee University College of MedicineSeoulRepublic of Korea Evidence-Based Research Laboratory Department of Clinical Pharmacy and Pharmaceutical CareCollege of PharmacyChung-Ang UniversitySeoulRepublic of Korea Parc Sanitari Sant Joan de Deu/CIBERSAM/ISCIII Universitat de BarcelonaFundacio Sant Joan de Déu.Sant Boi de LlobregatBarcelonaSpain ICREA Pg.Lluis Companys 23BarcelonaSpain Pain and Rehabilitation Centre and Department of Medical and Health SciencesLinkoping University58185 LinkopingSweden Department of Pediatrics Yonsei University College of MedicineYonsei-ro 50Seodaemun-gu8044Seoul 03722Republic of Korea Centre for Health Performanceand WellbeingAnglia Ruskin UniversityCambridge CB11PTUK Research Laboratory Psychology of Patients Families&Health ProfessionalsDepartment of NursingSchool of Health SciencesUniversity of IoanninaIoannina 45500Greece

Introduction Antibiotic use for acute otitis media(AOM)is one of the major sources of antimicrobial ***,the effective minimal antibiotic duration for AOM remains ***,guidelines often recommend broad ranges(5-10 days)of antibiotic use,yet the clinical impact of such a wide window has not been *** We systematically searched PubMed/MEDLINE,Embase,Scopus,Web of Science,and Cochrane Library from database inception to 6 October *** meta-analysis was conducted on randomized controlled trials that assessed antibiotic treatment for AOM in children(PROSPERO CRD42020196107).Results For 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 *** 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 *** to amoxicillin,a shorter treatment duration was tolerable with *** Our findings indicated that 1O days of antibiotic use may be unnecessarily long,while the treatment duration should be longer than 5 ***,5-day regimens would be sufficient for a modest treatment *** 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.

关键词： Amoxicillin-potassium Amoxicillin Antibacterial agents Cephalosporins Duration of therapy

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