PMID- 31561959
OWN - NLM
STAT- MEDLINE
DCOM- 20200518
LR  - 20200518
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 215
DP  - 2019 Dec
TI  - Adverse Events of Antibiotics Used to Treat Acute Otitis Media in Children: A 
      Systematic Meta-Analysis.
PG  - 139-143.e7
LID - S0022-3476(19)31101-1 [pii]
LID - 10.1016/j.jpeds.2019.08.043 [doi]
AB  - OBJECTIVE: To characterize the incidence of adverse events (AEs) associated with 
      antibiotics used to treat acute otitis media in children. STUDY DESIGN: We 
      searched MEDLINE for studies conducted between January 1, 1966, and August 25, 
      2018. Two authors independently assessed potential studies and extracted the 
      data. We included published randomized controlled trials, cross-sectional 
      studies, and cohort studies that evaluated the incidence of diarrhea, generalized 
      rash, diaper rash, and candidal diaper dermatitis associated with the use of 
      amoxicillin, amoxicillin/clavulanate, azithromycin, cefdinir, and placebo in 
      children with acute otitis media. RESULTS: We included 82 studies in the 
      meta-analysis. The incidence of diarrhea, listed from lowest to highest, was 
      azithromycin (2.2%), placebo (6.9%), low-dose amoxicillin (8.7%), cefdinir 
      (13.0%), high-dose amoxicillin (13.8%), and high-dose amoxicillin/clavulanate 
      (18.9%). The incidence of generalized rash, listed from lowest to highest, was 
      azithromycin (1.4%), placebo (2.3%), low-dose amoxicillin (2.9%), high-dose 
      amoxicillin/clavulanate (4.9%), and high-dose amoxicillin (6.5%). In studies of 
      low-dose amoxicillin, we found a higher incidence of diarrhea in studies that 
      used daily diaries to collect information about diarrhea and a lower incidence of 
      generalized rash in studies that reported only rashes judged to be secondary to 
      antibiotic use. CONCLUSIONS: The incidence of AEs varies widely depending on 
      which antibiotic is used and how the information on AEs was collected or 
      reported. The AEs rates reported here may be helpful to clinicians when choosing 
      an antibiotic to treat acute otitis media.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Hum, Stephanie W
AU  - Hum SW
AD  - Department of Pediatrics, University of Pittsburgh School of Medicine, 
      Pittsburgh, PA.
FAU - Shaikh, Kai J
AU  - Shaikh KJ
AD  - Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of 
      UPMC, Pittsburgh, PA.
FAU - Musa, Samar S
AU  - Musa SS
AD  - Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of 
      UPMC, Pittsburgh, PA.
FAU - Shaikh, Nader
AU  - Shaikh N
AD  - Department of Pediatrics, University of Pittsburgh School of Medicine, 
      Pittsburgh, PA; Division of General Academic Pediatrics, Children's Hospital of 
      Pittsburgh of UPMC, Pittsburgh, PA. Electronic address: nader.shaikh@chp.edu.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20190924
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
CIN - J Pediatr. 2020 Jul;222:253-257. PMID: 32586528
MH  - Acute Disease
MH  - Anti-Bacterial Agents/*adverse effects
MH  - Child
MH  - Drug-Related Side Effects and Adverse Reactions/*epidemiology
MH  - Global Health
MH  - Humans
MH  - Incidence
MH  - Otitis Media/*drug therapy
OTO - NOTNLM
OT  - amoxicillin
OT  - amoxicillin/clavulanate
OT  - azithromycin
OT  - candidal diaper dermatitis
OT  - cefdinir
OT  - diaper rash
OT  - diarrhea
OT  - rash
EDAT- 2019/09/29 06:00
MHDA- 2020/05/19 06:00
CRDT- 2019/09/29 06:00
PHST- 2019/05/31 00:00 [received]
PHST- 2019/07/17 00:00 [revised]
PHST- 2019/08/21 00:00 [accepted]
PHST- 2019/09/29 06:00 [pubmed]
PHST- 2020/05/19 06:00 [medline]
PHST- 2019/09/29 06:00 [entrez]
AID - S0022-3476(19)31101-1 [pii]
AID - 10.1016/j.jpeds.2019.08.043 [doi]
PST - ppublish
SO  - J Pediatr. 2019 Dec;215:139-143.e7. doi: 10.1016/j.jpeds.2019.08.043. Epub 2019 
      Sep 24.