Clinical Trials

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Browsing Clinical Trials by Author "Dawit, Gabriel"

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    Azithromycin versus amoxicillin-clavulanate for treatment of otitis media in children: a systematic review and meta-analysis of randomized controlled trials
    (Addis Abeba University, 2020-07) Dawit, Gabriel; Makonnen, Eyasu(Prof.); Abay, Solomon M.(PhD)
    Background: Otitis media is an ear infection middle that caused by bacteria or a viruses, which affects more children. Amoxicillin/clavulanate is the drug of choice for otitis media currently. However emergency of resistance, long duration of treatment and more adverse reactions make amoxicillin to be a less valuable choice for treating otitis media. Objective: The aim of this study is to compare the efficacy and safety of azithromycin against amoxicillin/clavulanate for the treatment of otitis media in children. Methodology: Two databases PubMed and Cochrane library were searched systematically and from Google scholar manually searched. The articles were screened by two review authors, duplicates were removed by Mendeley reference manager software. Remained search results was screened for fulfillment of PICOs and inclusion criteria. Articles which did not fulfill the PICO and inclusion criteria were excluded from the study. Data extracted by the first review author and checked by second author. For analysis, all the included studies for review are provide on a table with relevant findings. Meta-analysis was performed using STATA software version 16, and Mantel-Haenszel method and effect measure odds ratio was employed for data analysis, data synthesis and creating forest plot. Result: Seven hundred fifty one records were identified and fourteen studies have fulfilled the inclusion criteria. In twelve studies azithromycin had equivalent clinical efficacy and in the remaining two studies the bacteriologic efficacy of azithromycin is lower than amoxicillin/clavulante. Meta-analysis results showed a small statistical difference on efficacy in favor of amoxicillin/clavulanate after completion of treatment and there was no statistical significant difference on efficacy on follow up. There was statistically significant difference of clinical adverse events more in amoxicillin/clavulanate group than in azithromycin. Conclusion: Efficacy of azithromycin is not inferior to amoxicillin/clavulanate to treat otitis media in children, and it is more safe and tolerable in children than amoxicillin/clavulanate. Recommendations: Azithromycin can be a possible first line treatment option of otitis media. More up to date well controlled clinical trial researches are required to replace amoxicillin/clavuluanate.