What is the duration of antibiotic therapy for the 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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The duration of therapy is also empirically determined to some degree, and data indicate that significant numbers of children do not receive prescribed antibiotics beyond relief of acute symptoms. Traditionally, therapy is continued for 10-14 days; this is convenient for office scheduling, but it may not necessarily be more efficacious than 5 or even 2 days of therapy.

Short-duration therapy may not be appropriate in children younger than 2 years who appear prone to failure even after 14 days of therapy. Mandel showed that when an effusion-free ear was the prime objective, 20 days of antibiotic therapy achieved better outcomes than 10 days of therapy or placebo; however, after 90 days, no difference in the groups existed and recurrence was not prevented by the additional therapy.

Recommendations for administration of prescribed antimicrobials to treat AOM may differ from recommendations for the same antibiotic when used for soft tissue infections.

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