What are the CDC guidelines for the use of antibiotics for treatment 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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Some order has been brought to the discussions of antibiotic use under the auspices of the Centers for Disease Control and Prevention (CDC) and by the Agency for Health Care Policy and Research (AHCPR), both agencies of the US government. The CDC published 6 principles of appropriate antibiotic use in an attempt to bring precepts of good public health and responsible therapy to the discussion while minimizing the selection of resistant strains of bacteria within the community. These principles are as follows:

  • Episodes of otitis media should be classified as AOM or otitis media with effusion (OME)

  • Antimicrobials are indicated for treatment of AOM; however, diagnosis requires documented middle ear effusion and signs or symptoms of acute local or systemic illness

  • Uncomplicated AOM may be treated with a 5- to 7-day course of antimicrobials in certain patients older than 2 years

  • Antimicrobials are not indicated for the initial treatment of OME; treatment may be indicated if effusions persist for longer than 3 months

  • Persistent OME after therapy for AOM is expected and does not require repeat treatment with antimicrobials

  • Antimicrobial prophylaxis should be reserved for controlling recurrent AOM, defined as 3 or more distinct, well-documented episodes in 6 months or 4 or more episodes in 12 months

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