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The American Academy of Pediatrics and American Academy of Family Physicians have released a joint clinical practice guideline for management of acute otitis media (AOM). The guideline emphasizes that AOM requires accurate diagnosis (middle-ear effusion must be present) and that therapeutic options depend on age, diagnostic certainty, and severity of illness:
Infants (age, <6 months) should receive antibiotics.
Young children (age, 6 months to 2 years) should receive antibiotics when diagnosis is certain†. When diagnosis is uncertain, antibiotics should be given if illness is severe‡; observation is an option for mild-to-moderate illness§.
Older children (age, >2) should receive antibiotics when diagnosis is certain† and illness is severe‡; ob…