Effect on duration of symptoms

Evidence is available from a practice-based, double-blind, randomised controlled trial.

• over a two-year period, 240 children aged 6-24 months who presented with acute otitis media from 53 practices were recruited into the study. Children (185) were excluded from the study because of clinical need, withheld parent consent, prior antibiotic treatment or amoxycillin allergy
  
  
• children were randomised to treatment with amoxicillin for 10 days or placebo
  
  
• the main outcome measures used in the study were duration of pain and fever, persistent symptoms at day 4, otoscopy at day 4 and day 11, use of analgesics, and tympanometry at 6 weeks
  
  
• by day 4 symptoms were present in 72% of children on placebo and only 59% of children on amoxicillin. Duration of pain was, on average, a day longer in children treated with placebo. The prevalence of complications such as middle-ear effusion was similar in the two groups at 6 weeks

Reference:

• (1) BMJ (2000), 320, 350-4.