-AAP released a new clinical practice guideline for diagnosis and management of acute otitis media (AOM).
Key Action Statements:
Diagnosis if presence of middle ear effusion and
(1) moderate to severe bulging of tympanic membrane (TM) or new otorrhea or
(2) mild bulging of TM and recent ear pain or intense erythema of TM
Treatment options:
Severe unilateral or bilateral AOM (>6mo): give antibiotics. Severe AOM is defined as fever >102.2 (39 C), moderate/severe otalgia, or symptoms >48h.
Nonsevere unilateral AOM (6-23 months): Advise the parents to consider a period of close observation and follow up (24-72h). If the childs clinical status deteriorates give antibiotics.
Nonsevere bilateral AOM (6-23 months): give antibiotics.
Nonsevere unilateral or bilateral AOM (>24 months): Advise the parents to consider a period of close observation and follow up (24-72h). If the childs clinical status deteriorates, give antibiotics.
Reference: Pediatrics Vol. 131 No. 3 March 1, 2013
