{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:30:05Z","timestamp":1784194205470,"version":"3.55.0"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Acute otorrhea is a common problem in children with tympanostomy tubes. We recently demonstrated that treatment with antibiotic-glucocorticoid eardrops is clinically superior to oral antibiotics and initial observation. The aim of this study was to assess the cost-effectiveness of these three common treatment strategies for this condition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We performed an open-label pragmatic trial in which 230 children with acute uncomplicated tympanostomy-tube otorrhea were randomly allocated to receive 1 of 3 treatments: hydrocortisone-bacitracin-colistin eardrops, oral amoxicillin-clavulanate suspension, and initial observation (no assigned medication prescription to fill). Parents kept a daily diary capturing ear-related symptoms, health care resource use, and non\u2013health care costs for 6 months. At 2 weeks and 6 months, the study doctor visited the children at home performing otoscopy. Using a societal perspective, treatment failure (otoscopic presence of otorrhea at 2 weeks) and number of days with otorrhea as reported in the daily diary were balanced against the costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Antibiotic-glucocorticoid eardrops were clinically superior to oral antibiotics and initial observation both at 2 weeks and 6 months. At 2 weeks, mean total cost per patient was US$42.43 for antibiotic-glucocorticoid eardrops, US$70.60 for oral antibiotics, and US$82.03 for initial observation. At 6 months, mean total cost per patient was US$368.20, US$420.73, and US$640.44, respectively. Because of the dominance of eardrops, calculating incremental cost-effectiveness ratios was redundant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Antibiotic-glucocorticoid eardrops are clinically superior and cost less than oral antibiotics and initial observation in children with tympanostomy tubes who develop otorrhea.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-3141","type":"journal-article","created":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T00:21:47Z","timestamp":1429575707000},"page":"e1182-e1189","source":"Crossref","is-referenced-by-count":22,"title":["Cost-Effectiveness of Treatment of Acute Otorrhea in Children With Tympanostomy Tubes"],"prefix":"10.1542","volume":"135","author":[{"given":"Thijs M.A.","family":"van Dongen","sequence":"first","affiliation":[{"name":"Departments of Epidemiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne G.M.","family":"Schilder","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology,"},{"name":"Otorhinolaryngology, Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, Netherlands;"},{"name":"UCL ENT Clinical Trials Programme, Ear Institute, Faculty of Brain Sciences, University College London, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roderick P.","family":"Venekamp","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology,"},{"name":"Otorhinolaryngology, Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Ardine de Wit","sequence":"additional","affiliation":[{"name":"Public Health, Health Technology Assessment and Medical Humanities, Julius Center for Health Sciences and Primary Care, and"},{"name":"Department of Nutrition, Prevention and Care, National Institute of Public Health and the Environment, Bilthoven, Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert J.M.G.","family":"van der Heijden","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology,"},{"name":"Otorhinolaryngology, Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, Netherlands;"},{"name":"Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,5,1]]},"reference":[{"key":"2021120907142520200_B1","unstructured":"Health and Social Care Information Centre. 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