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June 10, 1998

Controversies: Treatment of Acute Otitis Media

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(22):1783-1785. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-22-jac80008

To the Editor.— Congratulations to Drs Culpepper and Froom1 for a superb article that highlights an observation we reported2 in a 1994 meta-analysis: antibiotics have only a modest impact on clinical resolution of AOM. Pooled data from 33 randomized trials yielded an 81% rate of spontaneous primary control, with a 14% increase in efficacy when antimicrobials were given in a subset of 4 controlled studies. Our study followed a strict a priori protocol, and took 7 investigators more than 3 years to complete. Quality variations among source articles, including the degree of blinding, were not significantly associated with outcome.

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