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The therapeutic decision whether or not to systematically supplement vitamin D in all children aged 0 to 5 years is a question that remains difficult to answer. In France, a multicenter epidemiological study shows that rickets is not very prevalent even though compliance with vitamin D intake is not known and can be considered imperfect because it is restrictive. Children under 5 with pigmented skin, immigrants or adopted children, as well as those exclusively breastfed are at risk of deficiency rickets. A better knowledge of the risk factors could make it possible to define a priority target population for supplementation. [ABSTRACT FROM AUTHOR]

Otorrhea is a common symptom of acute otitis media (AOM). It is sometimes the first and only symptom of a perforated AOM (absence of fever or pain). National and international recommendations consider it as a noisy symptom or a sign of seriousness of an AOM, justifying systematic oral antibiotic therapy, whatever the age of the child and whatever the symptomatic character (fever or pain). What randomized clinical trials (RCTs) or meta-analyses of RCTs support these recommendations? What is the effectiveness of oral or topical antibiotics in children with isolated otorrhea on AOM? A systematic review of RCTs and meta-analyses of RCTs (MA) concerning the antibiotic treatment of otorrhea isolated on AOM in children was conducted. The Medline and Cochrane databases were consulted until 30/07/2019. Results: No RCT or MA of RCT evaluated the effect of oral or topical antibiotic therapy in children with asymptomatic otorrhea following a perforated AOM. Conclusion: Current recommendations to systematically treat children with isolated otorrhea on AOM with antibiotics are not justified by an RCT. [ABSTRACT FROM AUTHOR]