Young children with otitis media treated with antibiotics for 10 days did better than those treated for 5 days, according to a trial in the New England Journal of Medicine.
Researchers randomized 520 children aged 6–23 months with acute otitis media to receive amoxicillin-clavulanate (90.0 mg/kg amoxicillin, 6.4 mg/kg clavulanate) for 10 days or amoxicillin-clavulanate for 5 days followed by 5 days of placebo.
Children receiving 5-day antibiotic therapy had a higher rate of clinical failure (34%) than those in the 10-day treatment group (16%). No differences in adverse events or nasal colonization with resistant bacteria were noted between treatment groups.
Comment: It is unfortunate that in this study a shorter antibiotic course was inferior for treating otitis media in children less than 2 years of age. Future studies should evaluate shorter antibiotic courses using different antibiotics and in older children.