Systemic antibiotics for chronic suppurative otitis media
Abstract
Background: Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Systemic antibiotics are commonly used to treat people with CSOM. This is the first update to the review published in 2021, and is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.
Objectives: To assess the effects of systemic antibiotics compared to placebo, no treatment, or another systemic antibiotic in people with chronic suppurative otitis media (CSOM).
Search methods: We searched the Cochrane Ear, Nose, and Throat Register, CENTRAL, MEDLINE, Embase, four other databases, and two clinical trials registers to 15 June 2022.
Selection criteria: We included randomised controlled trials comparing systemic antibiotics (oral, injection) to placebo/no treatment or other systemic antibiotics with at least a one-week follow-up period, involving people with chronic (at least two weeks) ear discharge of unknown cause or due to CSOM. Other treatments were allowed if both treatment and control arms received it.
Data collection and analysis: We used standard Cochrane methods. Our primary outcomes were: resolution of ear discharge or 'dry ear' (whether otoscopically confirmed or not,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,525 participants or records.
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