Limited evidence of effectiveness of analgesics in AOM in children

Despite explicit guideline recommendations on their use, current evidence on the effectiveness of paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), alone or combined, in relieving pain in children with AOM is limited. Low-quality evidence indicates both paracetamol and ibuprofen as monotherapies are more effective than placebo in relieving short-term (48 hours) ear pain in children with AOM (paracetamol NNT* 7; ibuprofen NNT 6). There is insufficient evidence of a difference between ibuprofen and paracetamol in relieving short-term (at 24 hours, 48–72 hours and 4–7 days) ear pain in children with AOM. Data on the effectiveness of ibuprofen plus paracetamol versus paracetamol alone are insufficient to draw any firm conclusions.

*NNT = number needed to treat to benefit 1 individual.