What are the treatment options for 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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Acute otitis media (AOM) has been described as a self-limiting disease, provided that the patient does not develop a complication. This is an old description that has a renewed relevance. In the new millennium, practitioners are forced to learn the lessons of history because these may serve as our models of practice without effective antimicrobial agents. Nevertheless, for the time being, antibiotics remain the initial therapy of choice for AOM.

Other pharmacologic therapies have also been used to treat AOM. Analgesics and antipyretics have a definite role in symptomatic management. Decongestants and antihistamines do not appear to have efficacy either early or late in the acute process, although they may relieve coexistent nasal symptoms. Systemic steroids have no demonstrated role in the acute phase.

Tympanocentesis and myringotomy are the procedures used to treat AOM. Certain patients require ventilation or drainage of the middle ear cleft for an extended period or have a history of repetitive attacks; these patients benefit from placement of a tympanostomy tube at the time of myringotomy.

Consultation is seldom necessary, although some otolaryngologists might be more comfortable having the pediatrician provide all the primary care.

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