Acute Otitis Media

Acute Otitis Media

Routine Practices

  • The following guidelines exclude the treatment of otitis media in children
    • less than 6 months of age,
    • those with craniofacial abnormalities,
    • immunocompromised children,
    • children with tympanostomy tubes, or
    • recurrent otitis media
  • Acute otitis media (AOM) is characterized by the acute onset of otalgia, with middle ear fluid and significant inflammation of the middle ear.
  • A 24 to 48-hour period of observation without antibiotics, called “watchful waiting,” may be considered in otherwise healthy children (ie, no underlying conditions) with mild signs and symptoms, and parents that are capable of recognizing signs of worsening illness and can readily access medical care if the child does not improve.
  • Children who have mild or moderate bulging tympanic membrane, who are mildly ill, alert, responsive to antipyretics, able to sleep, without rigors, have less than 48 hours of illness, have a fever of less than 39°C without the use of antipyretics and mild otalgia are possible candidates for “watchful waiting” strategy.

Common Pathogens

Duration of Therapy

Children 6 months to <2 years: 10 days

Children 2 years and older: 5 days

Persistent middle ear effusion after therapy for AOM is expected and does not require re-treatment.

More Information

Le Saux. CPS Statement on Management of AOM Available Here