CEDAR Study – Belated ‘Thank you’ to participating practices, parents and children

Please see the message below from the Research Team regarding a study we undertook in 2017. We were proud to contribute a small number of children to this study before it had to be halted due to lack of resources. Many thanks again for the parents and children that agreed to be involved.

The CEDAR Randomised Controlled Trial

Ear infections are common in children under ten years of age, with 40% of suffering an ear infection at least once a year. During the infection, germs multiply in the confined space of the middle ear resulting in a build-up of pressure that pushes on and stretches the ear drum. This causes severe pain and distress to the child, disrupting family life.

Although there is world class evidence showing that antibiotics do not help, and the National Institute for Clinical Excellence (NICE) advise against their use for the majority of children, over 85% of UK children with middle ear infections (acute otitis media) are prescribed an antibiotic – a higher percentage than for any other childhood infection. Antibiotics do not treat the child’s pain, and in most cases, they do not treat the infection (because many ear infections are caused by viruses which do not respond to antibiotics), but they can cause side-effects (such as diarrhoea) and increase the problem of antibiotic resistance, which is a major public health concern.

The CEDAR trial wanted to find out whether pain-killing ear drops (Auralgan) can, by treating children’s ear pain, reduce the number of parents giving antibiotics for acute otitis media. Children were either given the pain-killing drops, placebo (dummy) drops or usual care. We found that if the children were given pain-killing drops, significantly fewer of them were given antibiotics.

Unfortunately, due to medicine supply problems, there weren’t enough children who took part in the study to change advice on how doctors treat ear infections. However, we think these results suggest that ear drops help reduce unnecessary antibiotic use and should be investigated again in a larger study.

For more information, see https://www.journalslibrary.nihr.ac.uk/hta/hta23340#/abstract

Thank you once again for your help with this study

Professor Alastair Hay, CEDAR Chief Investigator