Effectiveness of Oral versus Topical Antibiotics in the Treatment of Pediatric Otitis Media

Background: Acute otitis media (AOM) is an infection of the middle ear and mastoid cavity. If left untreated, AOM may progress to chronic otitis media and may be difficult to treat leading to permanent loss of hearing and socioeconomical problems. Current evidence suggests that most children diagnosed with AOM are treated with immediate oral antibiotics; however, the use of topical antibiotics is on the rise. Purpose: There is little consensus on the effectiveness of oral antibiotics versus topical antibiotics in the treatment of otitis media in children. The purpose of the current review was to present the most recent (since 2015) available knowledge regarding the effectiveness of both oral and topical antibiotic treatments and weigh their efficacies. Methods: A comprehensive literature search was conducted using the PubMed database and the search term otitis media AND topical antibiotics AND oral antibiotics AND outcomes . Only original research studies on the pediatric population were considered. All outcomes included in the reviewed studies that helped compare the efficacy of the oral and topical antibiotics were considered. The comparative effect of the two types of drugs on each outcome was studied separately. Conclusions: Finally, nine studies were considered for the review. Compared to oral antibiotics, topical antibiotics showed a better effect on the outcomes of ear discharge, hearing, ear pain, being unwell, sleep disturbances, microbial eradication, recurrence, and parent satisfaction. In general, the topical antibiotic treatment seems to be a better choice in treating AOM