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Evidence summaries

Once or Twice Versus Three Times Daily Amoxicillin for Acute Otitis Media

Once or twice daily doses of amoxicillin, with or without clavulanate, compared to three daily doses may not differ in clinical cure rates for the treatment of acute otitis media. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 5 studies with a total of 1601 children. None of the studies reported a clearly significant outcome for benefits or harms. Due to moderate to high risk of biases among these studies, the authors did not perform pooled data analysis. The findings did not show statistical difference in the effectiveness of the two different dosages of amoxicillin, with or without clavulanate. The outcomes were assessed at the end of therapy (often 10 days) and this may have been too late to measure any differences.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding) and by inconsistency (heterogeneity in interventions and outcomes).

    References

    • Thanaviratananich S, Laopaiboon M, Vatanasapt P. Once or twice daily versus three times daily amoxicillin with or without clavulanate for the treatment of acute otitis media. Cochrane Database Syst Rev 2013;(12):CD004975. [PubMed]

Primary/Secondary Keywords