{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:41:02Z","timestamp":1761007262606,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"vor","delay-in-days":5418,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2001,11]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To familiarize otolaryngologists with the Agency for Healthcare Research and Quality (AHRQ) Evidence Report on Acute Otitis Media (AOM) that reviews the natural history and role of antibiotics in management. The report, by the Southern California Evidence\u2010Based Practice Center (SC\u2010EPC), is the most recent of 15 literature syntheses published by the AHRQ.<\/jats:p><\/jats:sec><jats:sec><jats:title>DATA SOURCES<\/jats:title><jats:p>MEDLINE (1966 to present), Cochrane Library, EMBASE, BIOSIS, HealthSTAR, and other computerized databases; manual reference search of proceedings, articles, reports, and guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY SELECTION<\/jats:title><jats:p>Randomized trials and cohort studies relevant to the natural history of AOM and the efficacy of antimicrobial therapy. AOM was defined by the 11\u2010member technical expert panel (including 2 authors, RMR and MLC) as middle\u2010ear effusion with the rapid onset of signs or symptoms of middle ear inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>DATA EXTRACTION<\/jats:title><jats:p>Two physician reviewers at the Southern California Evidence\u2010Based Practice Center independently rated the articles and extracted data.<\/jats:p><\/jats:sec><jats:sec><jats:title>DATA SYNTHESIS<\/jats:title><jats:p>Children receiving placebo or no antimicrobial had a pooled clinical success rate of 81% at 1 to 7\u00a0days (95% CI, 72% to 90%), with no increase in suppurative complications when followed closely. Amoxicillin or ampicillin increased the absolute success rate by 12.3% (95% CI, 2.8% to 21.8%) in 5 studies pooled using random effects meta\u2010analysis. The antimicrobial benefit was robust to sensitivity analysis. In contrast, success rates were not influenced by the choice or duration of therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The AHRQ report emphasizes middle\u2010ear effusion as a preeminent criteria for AOM diagnosis and provides extensive evidence tables on natural history and antimicrobial impact. About 8 children must receive antibiotics to avoid 1 clinical failure, but children younger than age 2 years or with severe symptoms may benefit more. The report is a starting point for organizations seeking to develop AOM guidelines, performance measures, and other quality improvement tools.<\/jats:p><\/jats:sec>","DOI":"10.1067\/mhn.2001.119326","type":"journal-article","created":{"date-parts":[[2003,2,4]],"date-time":"2003-02-04T21:49:09Z","timestamp":1044395349000},"page":"440-448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Implications of the AHRQ Evidence Report on Acute Otitis Media"],"prefix":"10.1002","volume":"125","author":[{"given":"Richard M.","family":"Rosenfeld","sequence":"first","affiliation":[{"name":"Department of Otolaryngology SUNY Health Science Center at Brooklyn Brooklyn New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaretha L.","family":"Casselbrant","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Children's Hospital of Pittsburgh Brooklyn New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen T.","family":"Hannley","sequence":"additional","affiliation":[{"name":"American Academy of Otolaryngology\u2013Head and Neck Surgery and Foundation Brooklyn New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7023.71"},{"volume-title":"Evidence\u2010based otitis media","year":"1999","author":"Rosenfeld RM","key":"e_1_2_14_3_1"},{"key":"e_1_2_14_4_1","first-page":"609","article-title":"How to systematically review the medical literature","volume":"122","author":"Rosenfeld RM","year":"1996","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.19.1836"},{"volume-title":"Otitis media with effusion in young children. 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