Outcomes of Treating Otitis Media With Effusion

Outcomes of Treating Otitis Media With Effusion *

Outcomes of Treating Otitis Table
Intervention Benefits‡ Harms‡
Observation Base case Base case
Antibiotics Improved clearance of effusion at 1 month or Nausea, vomiting, diarrhea (2% to 32% depending on
less, 14.0% (95% CI [3.6%, 24.2%]); possible dose and antibiotic); cutaneous reactions (<= 5%);
reduction in future infections numerous rare organ system effects, including very
rare fatalities; cost; possible development of resistant
strains of bacteria
Antibiotics plus steroids Possible improved clearance at 1 month, 25.1% See antibiotics and steroids separately
(95% CI [-1.3%, 49.9%])§; possible reduction
in future infections.
Steroids alone Possible improved clearance at 1 month, 4.5% Possible exacerbation of varicella; long-term
(95% CI [-11.7%, 20.6%])§ complications not established for low doses; cost
Antihistamine/decongestant Same as base case Drowsiness and/or excitability¶; cost
Myringotomy with tubes Immediate clearance of effusion in all children; Invasive procedure; anesthesia risk; cost;
improved hearing tympanosclerosis; otorrhea; possible restrictions on
swimming
Adenoidectomy Benefits for young children have not been Invasive procedure¶; anesthesia risk; cost
established
Tonsillectomy Same as base case Invasive procedure¶; anesthesia risk; cost
* The target patient is an otherwise healthy child age 1 through 3 years with no craniofacial or neurologic abnormalities or sensory deficits.
‡ Outcomes are reported as differences from observation, which is treated as the base case. When possible, meta-analysis was performed to provide a mean and associated confidence interval (CI).
§ Difference from base case not statistically significant.
¶ Risks were not examined in detail because no benefits were identified.