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Correspondence
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Volume 348:363 January 23, 2003 Number 4
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Otitis Media

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by Hendley, J. O.
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To the Editor: In the article on otitis media (Oct. 10 issue),1 Hendley's conclusions about the moderate value of antibiotics in acute otitis media are based largely on the results of published meta-analyses.2,3,4 Selecting studies for inclusion in meta-analyses requires consideration of methodologic issues. Among these is the definition of acute otitis media. Hendley stringently defines acute bacterial otitis media,1 but if studies evaluating the effect of antibiotic therapy have weak definitions (allowing the inclusion of children more likely to have otitis media with effusion than acute otitis media), the response in recipients of placebo will not differ much from . . . [Full Text of this Article]



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