Condition

Otitis media

Clinical trials and treatment information for Otitis media

121.2M
People Affected
60
Active Trials
700M
New Cases/Year
536
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Tympanostomy Tube Insertion
90% Effectiveness• 95% Confidence• 78% Safety• 60 trials• 50K participants
HIGH EvidenceGood Value
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
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Morphine💊
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78
DangerousModerateSafe

Time to Effect

immediate (hearing), days/weeks (AOM reduction)

Duration

6-18 months (tube indwelling)

Response Rate

93%

Remission Rate

88%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

15

Common Side Effects:

Otorrhea (ear discharge): 15%
Tympanosclerosis: 40%
Premature tube extrusion: 8%
Persistent tympanic membrane perforation (rare): 2%

Annual Cost of Care

Drug Cost

$0

Monitoring

$300

Side Effects

$100

Total Annual

$3,800

Cost-Effectiveness

GOOD

QALYs Gained

0.08

ICER

$25,000/QALY

Cost per Remission

$4,318

Cost per Responder

$4,086

Treatment Outcomes
Primary Outcomes
Acute Otitis Media (AOM) Episodes per Year4.5 episodes/year
-56% (-2.5 episodes/year)
Mean Proportion of Time with Middle Ear Effusion (MEE)65% of observation time
-85% (-55 percentage points)
Hearing Threshold (Pure Tone Average, PTA)28 dB HL (mild conductive hearing loss)
-64% (-18 dB HL)
Otitis Media-6 (OM-6) Quality of Life Score4.2/7.0 (higher indicates worse QoL)
-43% (-1.8 points)
Secondary Benefits
Number of Antibiotic Courses for AOM per Year3.8 courses/year
-53% (-2.0 courses/year)
Parental Stress Scale Score65/100 (higher indicates more stress)
-23% (-15 points)
Speech and Language Development Score (standardized age-equivalent)88 (mild delay, 100 is average)
+8% (+7 points)
Common Side Effects
Otorrhea (ear discharge)
+15%
Tympanosclerosis
+40%
Premature tube extrusion
+8%

Clinical Trial Phases:

Phase 4
2
Amoxicillin-Clavulanate
80% Effectiveness• 90% Confidence• 68% Safety• 17 trials• 20K participants
HIGH EvidenceModerate ValueDose: 90 mg/kg/day (amoxicillin component) in 2 divided doses
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
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68
DangerousModerateSafe

Time to Effect

2-3 days

Duration

5-10 days

Response Rate

85%

Remission Rate

80%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

7

Common Side Effects:

Diarrhea: 25%
Nausea/Vomiting: 8%
Rash: 3%

Annual Cost of Care

Drug Cost

$50

Monitoring

$50

Side Effects

$20

Total Annual

$120

Cost-Effectiveness

MODERATE

QALYs Gained

0.02

Cost per Remission

$150

Cost per Responder

$141

Treatment Outcomes
Primary Outcomes
Otitis Media Symptom Score (OMSS)OMSS: 8/14
-75% (-6 points on OMSS)
Ear Pain Severity (Wong-Baker FACES Pain Rating Scale)Pain Score: 6/10 (hurt a lot)
-66.7% (-4 points on Wong-Baker Scale)
Body Temperature101.5°F (38.6°C)
-69% (-2.0°F (-1.1°C))
Secondary Benefits
Child Irritability Score (Parent-reported)Irritability Score: 7/10
-57.1% (-4 points on Irritability Scale)
Sleep Disturbance Score (Parent-reported)Sleep Disturbance Score: 7/10
-50% (-3.5 points on Sleep Disturbance Scale)
Parental Absenteeism due to Child's Illness3 days
-66.7% (-2 days)
Common Side Effects
Diarrhea
+25%
Nausea/Vomiting
+8%
Rash
+3%

Clinical Trial Phases:

Phase 4
3
Amoxicillin
75% Effectiveness• 95% Confidence• 70% Safety• 18 trials• 100K participants
HIGH EvidenceModerate ValueDose: 80-90 mg/kg/day in 2-3 divided doses
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
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70
DangerousModerateSafe

Time to Effect

2-3 days

Duration

5-10 days

Response Rate

80%

Remission Rate

75%

Number Needed to Treat (NNT)

10

Number Needed to Harm (NNH)

15

Common Side Effects:

Diarrhea: 15%
Rash: 7%
Nausea/Vomiting: 3%

Annual Cost of Care

Drug Cost

$10

Monitoring

$50

Side Effects

$10

Total Annual

$70

Cost-Effectiveness

MODERATE

QALYs Gained

0.01

ICER

$120,000/QALY

Cost per Remission

$93

Cost per Responder

$88

Treatment Outcomes
Primary Outcomes
Ear Pain SeverityFACES Pain Scale score: 6/10 (moderate to severe pain)
-65% (-3.9 points)
Body Temperature38.5 °C (fever)
-2.6% (-1.0 °C)
Overall Symptom BurdenAcute Otitis Media Symptom Score (AOM-SS): 9/16
-60% (-5.4 points)
Secondary Benefits
Irritability ScoreParent-Reported Irritability Scale: 3/4 (significant irritability)
-50% (-1.5 points)
Sleep Disturbance SeverityParent-Reported Sleep Disturbance Scale: 7/10 (moderate to severe disturbance)
-50% (-3.5 points)
Parental Distress ScoreVisual Analog Scale (VAS) for Parental Distress: 7/10
-40% (-2.8 points)
Common Side Effects
Diarrhea
+15%
Rash
+7%
Nausea/Vomiting
+3%

Clinical Trial Phases:

Phase 4
4
Watchful Waiting / Symptomatic Treatment (Analgesics/Antipyretics)
70% Effectiveness• 90% Confidence• 95% Safety• 100 trials• 20K participants
HIGH EvidenceExcellent ValueDose: Age/weight-based for analgesics
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

3-7 days (symptom resolution)

Duration

As needed (symptoms), up to 3 months (OME)

Response Rate

75%

Remission Rate

65%

Annual Cost of Care

Drug Cost

$5

Monitoring

$50

Side Effects

$0

Total Annual

$55

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.005

Cost per Remission

$85

Cost per Responder

$73

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+70%
Response Rate
+75%
Remission Rate
+65%
5
Pneumococcal Conjugate Vaccine (PCV)
65% Effectiveness• 95% Confidence• 85% Safety• 2 trials• 200K participants
HIGH EvidenceExcellent ValueDose: Standard vaccine schedule
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe

Time to Effect

weeks-months (after series completion)

Duration

Childhood immunization series

Response Rate

%

Remission Rate

%

Number Needed to Treat (NNT)

25

Number Needed to Harm (NNH)

50000

Common Side Effects:

Injection site reactions (pain, redness): 40%
Fever: 10%
Irritability: 15%

Annual Cost of Care

Drug Cost

$500

Monitoring

$500

Side Effects

$0

Total Annual

$1,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$15,000/QALY

Treatment Outcomes
Primary Outcomes
Incidence of Vaccine-Type Acute Otitis Media0.2 episodes per child-year (unvaccinated)
-60% (-0.12 episodes per child-year)
Episodes of Recurrent Acute Otitis Media20% of children (unvaccinated) experience recurrent AOM
-25% (-5 percentage points)
Tympanostomy Tube Insertion Rate for AOM2.5 per 100 children (unvaccinated)
-30% (-0.75 per 100 children)
Antimicrobial Prescriptions for Acute Otitis Media0.8 prescriptions per child-year (unvaccinated)
-10% (-0.08 prescriptions per child-year)
Secondary Benefits
Incidence of All-Cause Acute Otitis Media0.5 episodes per child-year (unvaccinated)
-10% (-0.05 episodes per child-year)
Outpatient Visits for AOM0.6 visits per child-year (unvaccinated)
-10% (-0.06 visits per child-year)
Hospitalizations for AOM0.01 per 100 children (unvaccinated)
-20% (-0.002 per 100 children)
Common Side Effects
Injection site reactions (pain, redness)
+40%
Fever
+10%
Irritability
+15%

Clinical Trial Phases:

Phase 4