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2008 | OriginalPaper | Hoofdstuk
Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica?
Onderzoek: Een Individuele Patiënten Data meta-analyse
Auteurs : Maroeska Rovers, Paul Glasziou, Cees Appelman, Peter Burke, David McCormick, Roger Damoiseaux, Isabelle Gaboury, Paul Little, Arno Hoes
Gepubliceerd in: Schatjes zijn het
Uitgeverij: Bohn Stafleu van Loghum
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Samenvatting
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Inleiding Tot op heden is niet bekend welke kinderen met otitis media acuta (OMA) het meest gebaat zijn bij een behandeling met een antibioticum.
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Methoden Een IPD-meta-analyse met de individuele gegevens van 6 eerder uitgevoerde interventieonderzoeken (n = 1643 kinderen van 6 maanden tot 12 jaar) naar de effectiviteit van antibiotica bij kinderen met OMA. De nadruk lag op identificatie van subgroepen die meer of minder baat hebben. De primaire uitkomstmaat betrof een ongunstig beloop, gedefinieerd als pijn en/of koorts na 3 tot 7 dagen.
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Resultaten Van de kinderen jonger dan 2 jaar met dubbelzijdige OMA had 55% in de controlegroep en 30% in de antibioticagroep nog pijn en/of koorts na 3 tot 7 dagen. Het risicoverschil (RV) was dus –25% (95%-BI –36 - –14) en de NNT 4. Bij kinderen van 2 jaar of ouder met enkelzijdige OMA waren deze percentages respectievelijk 26 en 19% (RV –7%; 95%-BI –14-0; NNT 15). Het RV bij kinderen met looporen was –36% (95%-BI –53 - –19%) en de NNT was 3; bij kinderen zonder looporen was het risicoverschil –14% (95%-BI –23 - –5%) en de NNT 8.
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Beschouwing Antibiotica lijken effectief te zijn bij kinderen jonger dan 2 jaar met dubbelzijdige OMA en bij kinderen met een OMA en een loopoor. Voor de meeste andere kinderen lijkt een afwachtend beleid gerechtvaardigd. De NHG-Standaard Otitis media acuta bij kinderen is inmiddels aangepast conform deze bevindingen.
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Literatuur
1.
go back to reference Rovers MM, Schilder AG, Zielhuis GA, Rosenfeld RM. Otitis media. Lancet 2004;363:465-73.PubMedCrossRef
Rovers MM, Schilder AG, Zielhuis GA, Rosenfeld RM. Otitis media. Lancet 2004;363:465-73.PubMedCrossRef
2.
go back to reference Damoiseaux RAMJ, Van Balen FAM. Duration of clinical symptoms in children under two years of age with acute otitis media. Eur J Gen Pract 2000;6:48-51.CrossRef
Damoiseaux RAMJ, Van Balen FAM. Duration of clinical symptoms in children under two years of age with acute otitis media. Eur J Gen Pract 2000;6:48-51.CrossRef
3.
go back to reference Glasziou PP, Del Mar CB, Sanders SL, Hayem M. Antibiotics for acute otitis media in children (Cochrane Review). The Cochrane Library, Issue 1, 2004.
Glasziou PP, Del Mar CB, Sanders SL, Hayem M. Antibiotics for acute otitis media in children (Cochrane Review). The Cochrane Library, Issue 1, 2004.
4.
go back to reference Marcy M, Takata G, Shekelle P, et al. Management of Acute Otitis Media. Evidence Report/Technology Assessment No. 15 (Prepared by the Southern California Evidence-based Practice Center under Contract No. 290-97-0001). AHRQ Publication No. 01-E010. Rockville, MD: Agency for Healthcare Research and Quality; May 2001.
Marcy M, Takata G, Shekelle P, et al. Management of Acute Otitis Media. Evidence Report/Technology Assessment No. 15 (Prepared by the Southern California Evidence-based Practice Center under Contract No. 290-97-0001). AHRQ Publication No. 01-E010. Rockville, MD: Agency for Healthcare Research and Quality; May 2001.
5.
go back to reference Appelman CLM, Van Balen FAM, Van de Lisdonk EH, Van Weert HCPM, Eizenga WH. NHG-Standaard Otitis Media Acuta. Huisarts Wet 1999;42:362-6.
Appelman CLM, Van Balen FAM, Van de Lisdonk EH, Van Weert HCPM, Eizenga WH. NHG-Standaard Otitis Media Acuta. Huisarts Wet 1999;42:362-6.
6.
go back to reference Otters HBM, Van der Wouden JC, Schellevis FG, Van Suijlekom-Smit LWA, Koes BW. Trends in prescribing antibiotics for children with acute otitis media in Dutch general practice. J Antimicrob Chemother 2004;53:361-6.PubMedCrossRef
Otters HBM, Van der Wouden JC, Schellevis FG, Van Suijlekom-Smit LWA, Koes BW. Trends in prescribing antibiotics for children with acute otitis media in Dutch general practice. J Antimicrob Chemother 2004;53:361-6.PubMedCrossRef
7.
go back to reference Froom J, Culpepper L, Grob P, Bartelds A, Bowers P, Bridges-Webb C, et al. Diagnosis and antibiotic treatment of acute otitis media: report from International Primary Care Network. BMJ 1990;300:582-6.PubMedCentralPubMedCrossRef
Froom J, Culpepper L, Grob P, Bartelds A, Bowers P, Bridges-Webb C, et al. Diagnosis and antibiotic treatment of acute otitis media: report from International Primary Care Network. BMJ 1990;300:582-6.PubMedCentralPubMedCrossRef
8.
go back to reference Britten N, Ukoumunne O. The influence of patients’ hopes of receiving a prescription on doctors’ perceptions and the decision to prescribe: a questionnaire survey. BMJ 1997;315:1506-10.PubMedCentralPubMedCrossRef
Britten N, Ukoumunne O. The influence of patients’ hopes of receiving a prescription on doctors’ perceptions and the decision to prescribe: a questionnaire survey. BMJ 1997;315:1506-10.PubMedCentralPubMedCrossRef
9.
go back to reference MacFarlane J, Holmes W, MacFarlane R, Britten N. Influence of patients’ expectations on antibiotics management of acute lower respiratory illness in general practice: questionnaire study. BMJ 1997;315:1211-4.PubMedCentralPubMedCrossRef
MacFarlane J, Holmes W, MacFarlane R, Britten N. Influence of patients’ expectations on antibiotics management of acute lower respiratory illness in general practice: questionnaire study. BMJ 1997;315:1211-4.PubMedCentralPubMedCrossRef
10.
go back to reference Arason V, Kristinsson K, Sigurdsson J, Stefansdottir G, Molstad S, Gudmundsson S. Do antimicrobials increase the rate of penicillin resistant pneumococci in children? Cross sectional prevalence study. BMJ 1996;313:387-91.PubMedCentralPubMedCrossRef
Arason V, Kristinsson K, Sigurdsson J, Stefansdottir G, Molstad S, Gudmundsson S. Do antimicrobials increase the rate of penicillin resistant pneumococci in children? Cross sectional prevalence study. BMJ 1996;313:387-91.PubMedCentralPubMedCrossRef
11.
go back to reference De Chaput Saintonge DM, Levine DF, Temple Savage IT, Burgess GW, Sharp J, Mayhew SR, et al. Trial of three-day and ten-day courses of amoxycillin in otitis media. BMJ Clinical Research Edition 1982;284:1078-81.CrossRef
De Chaput Saintonge DM, Levine DF, Temple Savage IT, Burgess GW, Sharp J, Mayhew SR, et al. Trial of three-day and ten-day courses of amoxycillin in otitis media. BMJ Clinical Research Edition 1982;284:1078-81.CrossRef
12.
go back to reference Engelhard D, Strauss N, Jorczak-Sarni L, Cohen D, Sacjs TG, Shapiro M. Randomised study of myringotomy, amoxycillin/clavulanate, or both for acute otitis media in infants. Lancet 1989;2:141-3.PubMedCrossRef
Engelhard D, Strauss N, Jorczak-Sarni L, Cohen D, Sacjs TG, Shapiro M. Randomised study of myringotomy, amoxycillin/clavulanate, or both for acute otitis media in infants. Lancet 1989;2:141-3.PubMedCrossRef
13.
go back to reference Ostfeld E, Segal J, Kaufstein M, Gelernter I. Management of acute otitis media without primary administration of systemic antimicrobial agents. Lim DJ, Bluestone CD, Klein JO, Nelson JD, editors. Recent advances in otitis media. Proceedings of the Fourth International Symposium. Toronto: BC Decker, 1987:235-9.
Ostfeld E, Segal J, Kaufstein M, Gelernter I. Management of acute otitis media without primary administration of systemic antimicrobial agents. Lim DJ, Bluestone CD, Klein JO, Nelson JD, editors. Recent advances in otitis media. Proceedings of the Fourth International Symposium. Toronto: BC Decker, 1987:235-9.
14.
go back to reference Rudberg, RD. Acute otitis media: comparative therapeutic results of sulphonamide and penicillin administered in various forms. Acta Otolaryngology 1954;113(Suppl):1-79.
Rudberg, RD. Acute otitis media: comparative therapeutic results of sulphonamide and penicillin administered in various forms. Acta Otolaryngology 1954;113(Suppl):1-79.
15.
go back to reference Ruohola A, Heikkinen T, Meurman O, Puhakka T, Lindblad N, Ruuskanen O. Antibiotic treatment of acute otorrhea through tympanostomy tube: Randomized double-blind placebo-controlled study with daily follow-up. Pediatrics 2003;111:1061-7.PubMedCrossRef
Ruohola A, Heikkinen T, Meurman O, Puhakka T, Lindblad N, Ruuskanen O. Antibiotic treatment of acute otorrhea through tympanostomy tube: Randomized double-blind placebo-controlled study with daily follow-up. Pediatrics 2003;111:1061-7.PubMedCrossRef
16.
go back to reference Van Buchem F, Peeters M, Van ’t Hof M. Acute otitis media: a new treatment strategy. BMJ 1985;290:1033-7.PubMedCentralPubMedCrossRef
Van Buchem F, Peeters M, Van ’t Hof M. Acute otitis media: a new treatment strategy. BMJ 1985;290:1033-7.PubMedCentralPubMedCrossRef
17.
go back to reference Halsted C, Lepow ML, Balassanian N, Emmerich J, Wolinsky E. Otitis media: clinical observation, microbiology and evaluation of therapy. American Journal of Diseases of Children 1968;115:542-51.PubMedCrossRef
Halsted C, Lepow ML, Balassanian N, Emmerich J, Wolinsky E. Otitis media: clinical observation, microbiology and evaluation of therapy. American Journal of Diseases of Children 1968;115:542-51.PubMedCrossRef
18.
go back to reference Howie VM, Ploussard JH. Efficacy of fixed combination antibiotics versus separate components in otitis media: effectiveness of erythromycin estolate, triple sulfonamide, ampicillin, erythromycin estolate-triple sulfonamide, and placebo in 280 patients with acute otitis media under two and one-half years of age. Clin Pediatr (Phila) 1972;11:205-14.CrossRef
Howie VM, Ploussard JH. Efficacy of fixed combination antibiotics versus separate components in otitis media: effectiveness of erythromycin estolate, triple sulfonamide, ampicillin, erythromycin estolate-triple sulfonamide, and placebo in 280 patients with acute otitis media under two and one-half years of age. Clin Pediatr (Phila) 1972;11:205-14.CrossRef
19.
go back to reference Laxdal OE, Merida J, Jones RHT. Treatment of acute otitis media: a controlled study of 142 children. CMA Journal 1970;102:263-8.
Laxdal OE, Merida J, Jones RHT. Treatment of acute otitis media: a controlled study of 142 children. CMA Journal 1970;102:263-8.
20.
go back to reference Thalin A, Densert O, Larsson A, Lyden E, Ripa T. Is penicillin necessary in the treatment of acute otitis media? Proceedings of the International Conference on Acute and Secretory Otitis Media, Jerusalem. Amsterdam: Kugler Publications, 1985:441-6.
Thalin A, Densert O, Larsson A, Lyden E, Ripa T. Is penicillin necessary in the treatment of acute otitis media? Proceedings of the International Conference on Acute and Secretory Otitis Media, Jerusalem. Amsterdam: Kugler Publications, 1985:441-6.
21.
go back to reference Mygind N, Meistrup-Larsen K-I, Thomsen J, Thomsen VF, Josefsson K, Sorensen H. Penicillin in acute otitis media: a double-blind placebo-controlled trial. Clin Otolaryngol 1981;6:5-13.PubMedCrossRef
Mygind N, Meistrup-Larsen K-I, Thomsen J, Thomsen VF, Josefsson K, Sorensen H. Penicillin in acute otitis media: a double-blind placebo-controlled trial. Clin Otolaryngol 1981;6:5-13.PubMedCrossRef
22.
go back to reference Van Buchem FL, Dunk JHM, Van ’t Hof MA. Therapy of acute otitis media: myringotomy, antibiotics or neither? A double-blind study in children. Lancet 1981;2:883-7.PubMedCrossRef
Van Buchem FL, Dunk JHM, Van ’t Hof MA. Therapy of acute otitis media: myringotomy, antibiotics or neither? A double-blind study in children. Lancet 1981;2:883-7.PubMedCrossRef
23.
go back to reference Kaleida PH, Casselhrant ML, Rockette HE, Paradise JL, Bluestone CD, Blatter MM, et al. Amoxicillin or myringotomy or both for acute otitis media: results of a randomized clinical trial. Pediatrics 1991;87:466-74.PubMed
Kaleida PH, Casselhrant ML, Rockette HE, Paradise JL, Bluestone CD, Blatter MM, et al. Amoxicillin or myringotomy or both for acute otitis media: results of a randomized clinical trial. Pediatrics 1991;87:466-74.PubMed
24.
go back to reference Appelman CL, Claessen JQ, Touw-Otten FW, Hordijk GJ, De Melker RA. Co-amoxiclav in recurrent acute otitis media: placebo controlled study. BMJ 1991;303:1450-2.PubMedCentralPubMedCrossRef
Appelman CL, Claessen JQ, Touw-Otten FW, Hordijk GJ, De Melker RA. Co-amoxiclav in recurrent acute otitis media: placebo controlled study. BMJ 1991;303:1450-2.PubMedCentralPubMedCrossRef
25.
go back to reference Burke P, Bain J, Robinson D, Dunleavey J. Acute red ear in children: controlled trial of non-antibiotic treatment in general practice. BMJ 1991;303:558-62.PubMedCentralPubMedCrossRef
Burke P, Bain J, Robinson D, Dunleavey J. Acute red ear in children: controlled trial of non-antibiotic treatment in general practice. BMJ 1991;303:558-62.PubMedCentralPubMedCrossRef
26.
go back to reference Damoiseaux RA, Van Balen FA, Hoes AW, Verheij TJ, De Melker RA. Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ 2000;320:350-4.PubMedCentralPubMedCrossRef
Damoiseaux RA, Van Balen FA, Hoes AW, Verheij TJ, De Melker RA. Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ 2000;320:350-4.PubMedCentralPubMedCrossRef
27.
go back to reference Little P, Gould C, Williamson I, Moore M, Warner G, Dunleavey J. Pragmatic randomized controlled trial of two prescribing strategies for childhood acute otitis media. BMJ 2001;322:336-42.PubMedCentralPubMedCrossRef
Little P, Gould C, Williamson I, Moore M, Warner G, Dunleavey J. Pragmatic randomized controlled trial of two prescribing strategies for childhood acute otitis media. BMJ 2001;322:336-42.PubMedCentralPubMedCrossRef
28.
go back to reference Le Saux N, Gaboury I, Baird M, Klassen TP, MacCormick J, Blanchard C, et al. A randomized, double-blind, placebo-controlled noninferiority trial of amoxicillin for clinically diagnosed acute otitis media in children 6 months to 5 years of age. CMAJ 2005;172:335-41.PubMedCentralPubMedCrossRef
Le Saux N, Gaboury I, Baird M, Klassen TP, MacCormick J, Blanchard C, et al. A randomized, double-blind, placebo-controlled noninferiority trial of amoxicillin for clinically diagnosed acute otitis media in children 6 months to 5 years of age. CMAJ 2005;172:335-41.PubMedCentralPubMedCrossRef
29.
go back to reference McCormick DP, Chonmaitree T, Pittman C, Saeed K, Friedman NR, Uchida T, Baldwin CD. Nonsevere acute otitis media: a clinical trial comparing outcomes of watchful waiting versus immediate antibiotic treatment. Pediatrics 2005;115:1455-65.PubMedCrossRef
McCormick DP, Chonmaitree T, Pittman C, Saeed K, Friedman NR, Uchida T, Baldwin CD. Nonsevere acute otitis media: a clinical trial comparing outcomes of watchful waiting versus immediate antibiotic treatment. Pediatrics 2005;115:1455-65.PubMedCrossRef
30.
go back to reference Palmu AA, Herva E, Savolainen H, Karma P, Mäkelä PH, Kilpi TM. Association of Clinical Signs and Symptoms with Bacterial Findings in Acute Otitis Media. Clin Infect Dis 2004;38:234-242.PubMedCrossRef
Palmu AA, Herva E, Savolainen H, Karma P, Mäkelä PH, Kilpi TM. Association of Clinical Signs and Symptoms with Bacterial Findings in Acute Otitis Media. Clin Infect Dis 2004;38:234-242.PubMedCrossRef
31.
go back to reference Westert GP, Schellevis FG, De Bakker DH, Groenewegen PP, Bensing JM, Van der Zee J. Monitoring health inequalities through General Practice: the Second Dutch National Survey of General Practice. Eur J Publ Health 2005;15:59-65.CrossRef
Westert GP, Schellevis FG, De Bakker DH, Groenewegen PP, Bensing JM, Van der Zee J. Monitoring health inequalities through General Practice: the Second Dutch National Survey of General Practice. Eur J Publ Health 2005;15:59-65.CrossRef
32.
go back to reference Brookes ST, Whitley E, Peters TJ, Mulheran PA, Egger M, Davey Smith G. Subgroup analyses in randomised controlled trials: quantifying the risks of false-positives and false-negatives. Health Technol Assess 2001;5:1-56.PubMedCrossRef
Brookes ST, Whitley E, Peters TJ, Mulheran PA, Egger M, Davey Smith G. Subgroup analyses in randomised controlled trials: quantifying the risks of false-positives and false-negatives. Health Technol Assess 2001;5:1-56.PubMedCrossRef
Metagegevens
- Titel
- Welke kinderen met otitis media acuta hebben baat bij behandeling met antibiotica?
- Auteurs
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Maroeska Rovers
Paul Glasziou
Cees Appelman
Peter Burke
David McCormick
Roger Damoiseaux
Isabelle Gaboury
Paul Little
Arno Hoes
- Copyright
- 2008
- Uitgeverij
- Bohn Stafleu van Loghum
- Boek
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Schatjes zijn het
Print ISBN: 978-90-313-5342-2
Elektronisch ISBN: 978-90-313-6642-2
Copyright: 2008
- DOI
- https://doi.org/10.1007/978-90-313-6642-2_12