Comparing Watchful Waiting Approach vs. Antibiotic Therapy in Children with Nonsevere Acute Otitis Media: A Randomized Clinical Trial

Leila Shahbaznejad; Ensieh Talaei; Fatemeh Hosseinzadeh; Baraneh Masoumi; Shaghayegh Rezai; Mohammad Sadegh Rezai

doi:10.1155/2021/5515467

Comparing Watchful Waiting Approach vs. Antibiotic Therapy in Children with Nonsevere Acute Otitis Media: A Randomized Clinical Trial

Int J Pediatr. 2021 May 27:2021:5515467. doi: 10.1155/2021/5515467. eCollection 2021.

Authors

Leila Shahbaznejad¹, Ensieh Talaei¹, Fatemeh Hosseinzadeh¹, Baraneh Masoumi¹, Shaghayegh Rezai², Mohammad Sadegh Rezai¹

Affiliations

¹ Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
² Department of Microbiology and Virology, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Objective: To compare both approaches for the treatment of nonsevere acute otitis media (AOM) in Iran.

Methods: This randomized clinical trial was performed at a pediatric infectious diseases clinic in Buali tertiary hospital in Sari, north of Iran, from 2016 to 2018. All participants in this study were previously healthy children with AOM diagnosis, who were 6 months to 6 years old. The patients were randomly assigned into two groups: the intervention (80 mg/kg/day amoxicillin for 7-10 days) and the control group (watchful waiting approach). AOM recovery and adverse drug reactions were evaluated after 72 hours, and the patients were followed for the frequency of AOM and middle ear effusion 1 and 3 months' postintervention.

Results: A total of 396 children have participated in this study. AOM recovery was significantly different in the two groups (73% vs. 44% in the intervention and control groups, respectively). Recurrence of AOM and middle ear effusion (MEE) persistence, one month following the intervention, have not shown any significant differences between the two groups. However, the AOM recurrence between 1 and 3 months was more frequent in the control group. The frequency of diarrhea was also higher in the intervention group compared to the control but no significant difference was found between the two groups regarding vomiting and skin rash.

Conclusion: The faster recovery from AOM is achieved when an antibiotic treatment regimen is applied, although the risk of potential side effects should be considered.