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July 20, 1994

Antibiotics to Prevent Acute Otitis Media and to Treat Otitis Media With Effusion-Reply

Author Affiliations

Case Western Reserve University Cleveland, Ohio
Harvard School of Public Health Boston, Mass
Skagit Pediatrics Mt Vernon, Wash

JAMA. 1994;272(3):204. doi:10.1001/jama.1994.03520030043026

In Reply.  —Dr Cantekin's letter makes a number of unsubstantiated assertions. First, he is concerned about the heterogeneity of treatment effect in studies of antibiotic prophylaxis of recurrent acute otitis media. The DerSimonian and Laird analytic method we used assumes a random distribution of observed treatment effects about the true mean.1 Therefore, study heterogeneity is factored into the calculated estimate.Cantekin argues that sulfisoxazole is more effective than other antibiotics for prophylaxis against recurrent acute otitis media, but is unsafe. As detailed in our article, the data do not support recommendations for a specific antibiotic.2 Contrary to Cantekin's statements, there is no warning in the Physicians' Desk Reference about prophylactic use of sulfisoxazole as a single agent.Concerning the OME studies, Cantekin makes several statements about study quality and observed treatment effect. One of us (R.L.W.) reviewed his article on this topic and is aware he bases these

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