Rationale:
Acute otitis media (AOM) often resolves spontaneously within 1–3 days. Early antibiotic treatment does not reduce pain after 24 hours and should be withheld, with the option of reassessment if no improvement occurs within 2–3 days. Pain management is recommended, as 50% of children are pain-free within three days. Standard penicillin for five days should be given to children under 1 year of age and those with recurrent AOM ("otitis-prone" children) and may be considered in cases of bilateral AOM regardless of age.
References:
- Akutt otitis media
- https://www.cochrane.org/CD000219/ARI_antibiotics-for-acute-middle-ear-infection-acute-otitis-media-inchildren
- Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media.Pediatrics. 2013; 131(3):e964-999.
- Thompson M, Vodicka TA, Blair PS, et al. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ. 2013; 347:f702