Otitis Media: Physician Information Sheet (Pediatrics)
Careful Antibiotic Use
Otitis media with effusion does not require antibiotic treatment
Acute otitis media does not always require antibiotic treatment
Differentiating Acute Otitis Media (AOM) from Otitis Media with Effusion (OME):
A tool for promoting appropriate antibiotic use.1, 2
Always use pneumatic otoscopy or
tympanometry to confirm middle ear effusion
Not OME or AOM
|Yes effusion present|
Signs or symptoms of AOM-including ear pain, fever,
and bulging yellow or red TM
Management should include assessment of pain → if pain is present, clinician should recommend treatment to reduce pain.
Presence of effusion (including immobility of the tympanic membrane)
If the patient fails to respond to the initial management option within 48-72 hours, clinician must reassess to confirm AOM and exclude other causes of illness. If AOM is confirmed in:
- Patient initially managed with observation, begin antibacterial therapy.
- Patient initially managed with antibacterial agent, change the agent.
- American Academy of Pediatrics and American Academy of Family Physicians, Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media.
- Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B. Otitis media-Principles of judicious use of antimicrobial agents. Pediatrics 1998;101(1 Suppl Pt 2):165-71.
- Stool SE, Berg AO, Berman S, et al. Otitis media with effusion in young children. Clinical practice guideline. AHCPR Publication no 94-0622 1994.
- American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics Subcommittee on Otitis Media with Effusion. Otitis
media with effusion. Pediatrics 2004;113(5):1412-29.
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