Goals of Treatment: The goals are pain management, prudent antibiotic use, and secondary disease prevention. Acute otitis media should first be differentiated from otitis media with effusion or chronic otitis media.
Primary prevention of acute otitis media with vaccines should be considered. The seven-valent pneumococcal conjugate vaccine reduced the occurrence of acute otitis media by 6% to 7% during infancy.
Pain of otitis media should be addressed with oral analgesics. Acetaminophen or a nonsteroidal antiinflammatory agent, such as ibuprofen, should be offered early to relieve pain of acute otitis media.
Children 6 months to 12 years of age, with moderate to severe ear pain or temperature of 39°C (102.2°F) or higher should receive antibiotics. Children 6 to 23 months of age, with nonsevere bilateral acute otitis media should also receive antibiotics. Children 6 to 23 months, with nonsevere unilateral acute otitis media, ...