What is the prognosis of acute otitis media (AOM)?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Death from AOM is rare in the era of modern medicine. With effective antibiotic therapy, the systemic signs of fever and lethargy should begin to dissipate, along with the localized pain, within 48 hours. Children with fewer than 3 episodes are 3 times more likely to resolve with a single course of antibiotics, as are children who develop AOM in nonwinter months. Typically, patients eventually recover the conductive hearing loss associated with AOM.

Middle ear effusion and conductive hearing loss can be expected to persist well beyond the duration of therapy, with up to 70% of children expected to have middle ear effusion after 14 days, 50% at 1 month, 20% at 2 months, and 10% after 3 months, irrespective of therapy.

In most instances, persistent middle ear effusion can merely be observed without antimicrobial therapy; however, a second course of either the same antibiotic or a drug of a different mechanism of action may be warranted to prevent a relapse before resolution.

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