Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes.
Population: Children (age range 6 months to 17 years) ᵃ
Intervention: Influenza vaccine
Comparison: Placebo or no treatment
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
At least one episode of acute otitis media (follow‐up: 11 days to 1 year) | No statistically significant difference | Low |
Use of antibiotics (follow‐up: 1 month to 1 year) | Favors intervention | Moderate |
Adverse events - fever (follow‐up 11 days to 2 years) | Occurs more commonly with influenza vaccine compared with placebo or no treatment (favors comparison) | Low |
Adverse events ‐ rhinorrhea (follow‐up 11 days to 2 years) | Occurs more commonly with influenza vaccine compared with placebo or no treatment (favors comparison) | Low |
Adverse events ‐ pharyngitis (follow‐up 11 days to 1 year) | No statistically significant difference | Low |
Note The Cochrane review, which this Cochrane Clinical Answer (CCA) is based on, states that there was a small but not statistically significant reduction in the number of children having at least one episode of acute otitis media. The authors therefore concluded that “promoting influenza vaccination solely to reduce acute otitis media therefore does not seem justified”. However, they did state that the evidence could help parents make a decision on whether their child should have the influenza vaccine. They also stated that it is unclear whether the reduction in use of antibiotics is relevant to settings where a ‘watchful-waiting’ approach is appropriate. ᵃ Ten studies were included. Only one reported that all children had a history of recurrent acute otitis media.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- For people with respiratory infection, how do delayed compare with immediate or no antibiotic prescriptions?
- In children and adolescents with acute otitis media, how do topical anesthetic ear drops affect outcomes?
- Can probiotics help prevent acute otitis media (AOM) in children?
- In infants and children, do influenza vaccines help to prevent acute otitis media?
- In children up to 12 years of age, what are the benefits and harms of xylitol for preventing acute otitis media?
- In children at high risk of acute and chronic suppurative otitis media, is there randomized controlled trial evidence to support the use of antibiotic prophylaxis?
Use of this content is subject to our disclaimer