Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
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.
Rosenfeld RM. Controversies: Treatment of Acute Otitis Media. JAMA. 1998;279(22):1783–1785. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-22-jac80008