Systemic Corticosteroids in Pediatric Otitis Media: A Systematic Review and Meta-Analysis

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Systemic Corticosteroids in Pediatric Otitis Media: A Systematic Review and Meta-Analysis

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https://doi.org/10.54963/entu.v15i4.1670
Alshahrani, H., Alshammari, A., Alshammari, S., Alshaikh, Z., Alahamdi, L., Alqathanin, W., Alnujaimi, W., Alfaqih, F., Bandar, S., Malawi, L. A., Altuwijri, L., Almuzaini, R., Alhelali, Y. A., Alward, S., & Alshahrani, K. (2025). Systemic Corticosteroids in Pediatric Otitis Media: A Systematic Review and Meta-Analysis. ENT Updates, 15(4), 52–64. https://doi.org/10.54963/entu.v15i4.1670
Volume 15 Issue 4 (2025)
Copyright (c) 2025 Hayat Alshahrani, Areej Alshammari, Shoug Alshammari, Zainab Alshaikh, Lujain Alahamdi, Wajan Alqathanin, Wafaa Alnujaimi, Fatimah Alfaqih, Shahad Bandar, Leen Al Malawi, Lama Altuwijri, Raghida Almuzaini, Yazeed A. Alhelali, Sahar Alward, Kholoud Alshahrani
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors

  • Hayat Alshahrani

    Department of Doctor of Pharmacy, College of Clinical Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Areej Alshammari

    Home Health Care—Adult, King Abdulaziz Medical City, Ministry of National Guard, Riyadh 14611, Saudi Arabia
  • Shoug Alshammari

    Department of Doctor of Pharmacy, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
  • Zainab Alshaikh

    Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
  • Lujain Alahamdi

    Department of Doctor of Pharmacy, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
  • Wajan Alqathanin

    Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Wafaa Alnujaimi

    Dr Sulaiman Al Habib Medical Group, Riyadh 11643, Saudi Arabia
  • Fatimah Alfaqih

    Department of Medicine and Surgery, College of Medicine, Umm Al Qura University, Al Qunfudhah 28821, Saudi Arabia
  • Shahad Bandar

    Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Leen Al Malawi

    Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Lama Altuwijri

    Department of Doctor of Pharmacy, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
  • Raghida Almuzaini

    Department of Doctor of Pharmacy, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
  • Yazeed A. Alhelali

    College of Medicine, King Khalid University, Abha 62521, Saudi Arabia
  • Sahar Alward

    Department of Doctor of Pharmacy, College of Pharmacy, King Khalid University, Abha 62521, Saudi Arabia
  • Kholoud Alshahrani

    Pharmacy Department, Southern Region Armed Forces Hospital, Khamis Mushait 62413, Saudi Arabia

Received: 30 September 2025; Revised: 8 December 2025; Accepted: 17 December 2025; Published: 31 December 2025

Otitis media is a common childhood condition that affects public health because of its frequency, recurrence, and potential long-term consequences. This systematic review and meta-analysis assessed the efficacy and safety of systemic corticosteroids (SCS) in children with acute otitis media and otitis media with an effusion. A comprehensive search of PubMed, Scopus, and Web of Science identified relevant studies published between January 2018 and August 2025. The primary outcomes were effusion resolution, hearing loss, and otitis media recurrence. Secondary outcomes included pain relief, tympanostomy tube placement, speech and language development, quality of life, and adverse events. Four studies, including two Cochrane reviews, one randomized controlled trial, and one meta-analysis, were analyzed. The results showed that SCS provided short-term improvements in effusion clearance and hearing, with risk ratios from 1.08 to 1.20. However, these benefits were temporary, with no significant long-term effects on recurrence rates, persistent effusion, or developmental outcomes. Safety data were limited, with most adverse events being mild and self-resolving. The studies had moderate heterogeneity due to differences in population characteristics, intervention protocols, and outcome definitions. Results suggest that SCS may offer short-term symptom relief in certain cases but cannot be recommended for routine management of pediatric otitis media. Future research should prioritize large-scale multicenter trials with standardized outcomes, extended follow-up periods, and thorough safety assessments to identify the subgroups that might benefit the most from SCS treatment.

Keywords:

Otitis Media Acute Otitis Media Otitis Media with Effusion Intranasal Corticosteroids Systemic Corticosteroids

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