Do Children with AOM Need Antibiotics?

American Academy of Pediatrics guidelines (Journal Watch May 14 2004) indicate that children with nonsevere acute otitis media (AOM) can be observed rather than treated with antibiotics at the time of diagnosis. Investigators in Texas randomized 223 children (age, 6 months–12 years) with nonsevere disease to either watchful waiting (WW) or oral antibiotics (amoxicillin, 90 mg/kg daily; maximum dose, 1500 mg).

Children who received antibiotics reached symptom resolution (as reported by parents) significantly faster than children in the WW group. Parent satisfaction scores were identical in the two groups on days 12 and 30. On day 12, parents of children younger than 2 years in the antibiotic group reported global health status improvement mor…