Otitis Media: Physician Information Sheet (Pediatrics)
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Careful Antibiotic Use
Otitis media with effusion does not require antibiotic treatment
Acute otitis media does not always require antibiotic treatment
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Otitis Media
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 |
No effusion Not OME or AOM |
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Yes effusion present | ||||||||||||||||||
Signs or symptoms of AOM-including ear pain, fever, and bulging yellow or red TM |
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Yes |
No |
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AOM
Treatment Management should include assessment of pain → if pain is present, clinician should recommend treatment to reduce pain.
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OME
Presence of effusion (including immobility
Treatment
Share this algorithm with parents. Avoiding unnecessary treatment of |
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.
References
- American Academy of Pediatrics and American Academy of Family Physicians, Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media.
Pediatrics 2004;113(5):1451-65. - 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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