Antibiotics for Otitis Media

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Recommendation

Don't prescribe antibiotics for otitis media in children aged 2-12 years with non-severe symptoms where the observation option is reasonable.

  • The “observation option” refers to deferring antibacterial treatment of selected children for 48 to 72 hours and limiting management to symptomatic relief.
  • The decision to observe or treat is based on the child’s age, diagnostic certainty, and illness severity. To observe a child without initial antibacterial therapy, it is important that the parent or caregiver has a ready means of communicating with the clinician. There also must be a system in place that permits reevaluation of the child.

Sources
AAP/AAFP 2005 "Diagnosis and Management of Acute Otitis Media." Accessible at: http://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/final_aom.pdf

Venekamp RP, Sanders S, Glasziou PP, Del Mar CB, Rovers MM. Antibiotics for acute otitis media in children. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000219. DOI: 10.1002/14651858.CD000219.pub3. Accessible at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000219.pub3/pdf(onlinelibrary.wiley.com).