From the Guidelines
Treatment for acute otitis media typically involves antibiotics, such as amoxicillin, to help clear the infection. The choice of antibiotic depends on the severity of the infection, the patient's age, and any underlying medical conditions. According to the latest guidelines from the World Health Organization, amoxicillin is recommended as the first-choice antibiotic for acute otitis media, with amoxicillin-clavulanic acid as a second-choice option 1.
- For children under 2 years of age with bilateral otitis media, antibiotic therapy is recommended 1.
- For children over 2 years of age, a strategy of watchful waiting may be considered, unless they have marked symptoms such as high fever or intense earache 1.
- Pain management with over-the-counter medications like acetaminophen or ibuprofen may also be recommended to help alleviate symptoms such as ear pain and fever 1.
- Watchful waiting may be considered for mild cases, where the infection is monitored and treated only if symptoms worsen or persist 1.
- It is essential to note that the use of antibiotics should be judicious, as their routine use can lead to adverse effects and enhance the risk of antimicrobial resistance 1.
From the Research
Diagnosis and Treatment of Acute Otitis Media
The treatment for acute otitis media (AOM) typically involves antibiotic therapy, with the choice of antibiotic depending on the severity of symptoms and the likelihood of resistance [(2,3)].
- High-dose amoxicillin (80 to 90 mg per kg per day) is the preferred treatment for AOM in patients who are not allergic to penicillin 3.
- For patients with more severe symptoms or those who do not respond to initial treatment, amoxicillin/clavulanate may be used as a second-line agent [(2,3)].
- In some cases, particularly for children over 2 years old with mild symptoms, antibiotic therapy may be deferred in favor of watchful waiting [(3,4)].
Management of Symptoms
In addition to antibiotic therapy, management of AOM should include adequate analgesia to relieve pain and discomfort 3.
- Children with persistent symptoms despite 48 to 72 hours of antibiotic therapy should be reexamined, and alternative treatments may be considered 3.
Prevention and Future Directions
While current vaccines, such as pneumococcal and influenza vaccines, can help prevent some cases of AOM, they are not effective against all strains of bacteria that can cause the infection 5.
- The development of new, multi-species vaccines is an area of ongoing research, with the goal of reducing the global burden of AOM 5.