Management of Acute Otitis Media

Abstract

Our objective with this report was to analyze the evidence on the initial management of uncomplicated acute otitis media (AOM) in children. We assessed three questions: What is the natural history of AOM without antibiotic treatment? Are antibiotics effective in preventing clinical failure? and What is the relative effectiveness of specific antibiotic regimens such as: (1) amoxicillin or trimethoprim-sulfamethoxazole vs. other antibiotics, (2) oral fluoroquinolones, (3) >60 mg/kg/day amoxicillin or amoxicillin-clavulanate vs. 40 mg/kg/day, (4) high-dose amoxicillin therapy twice a day vs. three times a day, and (5) short-term vs. long-term antibiotic therapy?