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Otitis media remains the most common infection for which children receive antibiotics. Drawing on systematic reviews of the published literature, four leading "ear experts" offer the following observations:
Breast-feeding is protective against acute otitis media (AOM).
Daycare outside of the home, parental smoking, and pacifier use increase the risk for AOM.
Middle ear effusion (MEE) is a prerequisite for the diagnosis of both AOM and otitis media with effusion (OME); pneumatic otoscopy offers excellent sensitivity and specificity for detecting MEE.
Although AOM resolves spontaneously in about 80% of older children, this rate is substantially lower in children younger than 2 years.
Children younger than 2 years with a firm diagnosis of AOM shoul…