Adult Guidance
Acute Otitis Media

Acute Otitis Media

Definition

Infection of the middle ear that is rare in adults, often as a complication of a viral upper respiratory tract infection

Diagnosis

Acute onset of ear pain (unilateral or bilateral), fever (≥38.0ºC), +/- ear discharge

  • Not needed unless a complication is suspected
  • Cultures of pus from perforated ear drums should not be used to guide treatment

Not needed unless a complication is suspected

Not needed unless a complication (e.g. mastoiditis, brain abscess) is suspected

Required for definitive diagnosis if available: Bulging, inflamed/congested tympanic membrane (may be opaque/show decreased mobility)

Microbiology

Prevention

  • Overlaps with prevention of upper respiratory tract infections
  • Hand hygiene, vaccination against Streptococcus pneumoniae, influenza, and SARS-CoV-2 viruses can be useful

Treatment

Important: Most non-severe cases can be managed symptomatically with no antibiotic treatment

  • Instruct patients to monitor symptoms and report back in case they worsen/persist after few days

Antibiotics should be considered if:

  • Severe symptoms (e.g. systemically very unwell, ear pain despite analgesics, fever ≥39.0°C)

Additional Information

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