Ref (type)	Population	Outcome, Interventions	Results and statistical analysis	Effect size	Favours
General adverse effects
Systematic review	Children with otitis media with effusion (OME) in secondary care and selected (air force base) settings	Adverse effects with corticosteroids with placebo
Nasal adverse effects
RCT	217 children aged 4 to 11 years with bilateral OME	Stinging in nose 1 month 9/96 (9%) with intranasal corticosteroids 10/102 (10%) with placebo	RR 0.96 95% CI 0.41 to 2.25 P = 0.92		Not significant
RCT	217 children aged 4 to 11 years with bilateral OME	Stinging in nose 3 months 9/85 (11%) with intranasal corticosteroids 9/85 (11%) with placebo	RR 1.00 95% CI 0.42 to 2.40 P = 1		Not significant
RCT	217 children aged 4 to 11 years with bilateral OME	Nosebleed 1 month 8/97 (8%) with intranasal corticosteroids 7/101 (7%) with placebo	RR 1.19 95% CI 0.45 to 3.16 P = 0.73		Not significant
RCT	217 children aged 4 to 11 years with bilateral OME	Nosebleed 3 months 10/86 (12%) with intranasal corticosteroids 6/84 (7%) with placebo	RR 1.63 95% CI 0.62 to 4.28 P = 0.32		Not significant
Cough as an adverse effect
RCT	217 children aged 4 to 11 years with bilateral OME	Cough 1 month 23/97 (24%) with intranasal corticosteroids 19/102 (19%) with placebo	RR 1.27 95% CI 0.74 to 2.19 P = 0.38		Not significant
RCT	217 children aged 4 to 11 years with bilateral OME	Cough 3 months 19/86 (22%) with intranasal corticosteroids 11/83 (13%) with placebo	RR 1.67 95% CI 0.85 to 3.29 P = 0.13		Not significant
Throat adverse effects
RCT	217 children aged 4 to 11 years with bilateral OME	Dry throat 1 month 13/96 (14%) with intranasal corticosteroids 14/102 (14%) with placebo	RR 0.99 95% CI 0.49 to 1.99 P = 1		Not significant
RCT	217 children aged 4 to 11 years with bilateral OME	Dry throat 3 months 10/85 (12%) with intranasal corticosteroids 7/83 (8%) with placebo	RR 1.40 95% CI 0.56 to 3.49 P = 0.47		Not significant