Treatment of Acute Otitis Media (AOM) in Children

Acute otitis media is the commonest diagnosis in sick children visiting the pediatrician's office in the United States.

Middle ear effusion is common after the resolution of acute symptoms. It may persist for three months in 10%. If persistent it can cause conductive hearing loss and may affect speech, language, and cognitive ability.

Treatment of involves pain relief and antibiotics.

Motrin (ibuprofen), Tylenol(crocin/parecetamol/acetaminophen) are effective for pain.

Less than 24 month olds should always get antibiotics. Older kids with bilateral infection should also always get antibiotics. Otherwise healthy, older children with unilateral infection may be observed without antibiotics.

Amoxicillin is the usual first-line therapy and duration is usually 7 days. If they persist to have symptoms despite 48-72 hours of treatment may be changed to Augmentin(amoxicillin-clavulinic acid).

Less than 2 year olds and older kids with language deficits should have a follow up visit 2-3 months from the acute infection to ensure resolution of effusion.