Feature Article

Managing acute otitis media: what the GP needs to know

Feature Article

Managing acute otitis media: what the GP needs to know

Harvey Coates

Abstract

Diagnosis of acute otitis media in the febrile, screaming child may be difficult. Only 40% of children with red tympanic membranes have acute otitis media. When the diagnosis is uncertain, consider supportive treatment for 24 to 48 hours, and prescribe antibiotics only if symptoms persist.

Key Points

  • Only 40% of children with ‘red ears’ have acute otitis media. If a diagnosis of acute otitis media is doubtful consider 24 to 48 hours of conservative management.
  • Amoxycillin remains the treatment of choice for patients with acute otitis media; if there are resistant organisms higher doses or treatment with amoxycillin/potassium clavulanate or cefaclor may be needed.
  • Recurrent otitis media (that is, three to four episodes per year) with underlying persistent middle ear effusion warrants insertion of ventilation tubes.
  • Referral for specialist care and management is warranted for the neonate and young infant with persistent disease, or when there are complications.