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Fear of drug resistance has fueled a recent trend to withhold antibiotics in favor of analgesics for treatment of otitis media (OM) in children older than 2 years. Investigators in the Netherlands prospectively randomized 240 children (ages, 6 months to 2 years) who presented to 53 general practices with acute OM to receive either amoxicillin or placebo.
Parents kept diaries of adverse effects and use of the study drug, decongestant nose drops, and analgesics. Children were reassessed after 4 and 11 days and again at 6 weeks. In the amoxicillin group, analgesics were used less frequently, and the duration of fever, pain, and crying was 1 day shorter. Diarrhea occurred in 17% of the amoxicillin group versus 10% of controls. One patient in the…