Adverse Events of Antibiotics Used to Treat Acute Otitis Media in Children: A Systematic Meta-Analysis

To characterize the incidence of adverse events (AEs) associated with antibiotics used to treat acute otitis media in children. We searched MEDLINE for studies conducted between January 1, 1966, and August 25, 2018. Two authors independently assessed potential studies and extracted the data. We incl...

Full description

Saved in:

Bibliographic Details
Published in:	The Journal of pediatrics Vol. 215; pp. 139 - 143.e7
Main Authors:	Hum, Stephanie W., Shaikh, Kai J., Musa, Samar S., Shaikh, Nader
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-12-2019
Subjects:	Acute Disease amoxicillin amoxicillin/clavulanate Anti-Bacterial Agents - adverse effects azithromycin candidal diaper dermatitis cefdinir Child diaper rash diarrhea Drug-Related Side Effects and Adverse Reactions - epidemiology Global Health Humans Incidence Otitis Media - drug therapy rash rash amoxicillin amoxicillin/clavulanate cefdinir AE azithromycin candidal diaper dermatitis diarrhea diaper rash AOM
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To characterize the incidence of adverse events (AEs) associated with antibiotics used to treat acute otitis media in children. We searched MEDLINE for studies conducted between January 1, 1966, and August 25, 2018. Two authors independently assessed potential studies and extracted the data. We included published randomized controlled trials, cross-sectional studies, and cohort studies that evaluated the incidence of diarrhea, generalized rash, diaper rash, and candidal diaper dermatitis associated with the use of amoxicillin, amoxicillin/clavulanate, azithromycin, cefdinir, and placebo in children with acute otitis media. We included 82 studies in the meta-analysis. The incidence of diarrhea, listed from lowest to highest, was azithromycin (2.2%), placebo (6.9%), low-dose amoxicillin (8.7%), cefdinir (13.0%), high-dose amoxicillin (13.8%), and high-dose amoxicillin/clavulanate (18.9%). The incidence of generalized rash, listed from lowest to highest, was azithromycin (1.4%), placebo (2.3%), low-dose amoxicillin (2.9%), high-dose amoxicillin/clavulanate (4.9%), and high-dose amoxicillin (6.5%). In studies of low-dose amoxicillin, we found a higher incidence of diarrhea in studies that used daily diaries to collect information about diarrhea and a lower incidence of generalized rash in studies that reported only rashes judged to be secondary to antibiotic use. The incidence of AEs varies widely depending on which antibiotic is used and how the information on AEs was collected or reported. The AEs rates reported here may be helpful to clinicians when choosing an antibiotic to treat acute otitis media.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0022-3476 1097-6833
DOI:	10.1016/j.jpeds.2019.08.043