Treating Acute Otitis Media in Young Children

What Constitutes Success?

Jack L. Paradise, MD; Alejandro Hoberman, MD; Howard E. Rockette, PhD; Nader Shaikh, MD, MPH


Pediatr Infect Dis J. 2013;32(7):745-747. 

In This Article

Reactions to Study Findings

Reactions to the report of our findings were mixed. On one hand, an editorial accompanying our report and that of a similarly designed Finnish study[7] with similar outcomes commented, "The investigators … have provided the best data yet … more young children with a certain diagnosis of acute otitis media recover more quickly when they are treated with an appropriate antimicrobial agent."[8]

Other commenters,[9] on the other hand, were unapproving. Their criticisms centered mainly on what they considered the unimpressive magnitude of the differences we had found favoring the amoxicillin-clavulanate group over the placebo group in symptomatic response, and they questioned whether that advantage outweighed the side effects of antibiotic treatment—in this case, mainly diarrhea and diaper dermatitis—and the risk that the treatment imposed of promoting bacterial resistance. The criticisms either ignored the larger between-group difference we had found in the persistence of otoscopic signs of infection or disparaged that difference as of dubious clinical importance.