Guidelines
Acute Otitis Media (AOM)

Acute Otitis Media (AOM)

Clinical/Diagnostic Considerations

Otoscopic criteria: Middle ear effusion AND inflammation (bulging, red/ yellow tympanic membrane (TM)) OR acute perforation of TM.

AOM will often resolve spontaneously over 24-72 h.   

Mild or moderate illness: alert, responsive, responds well to analgesia, <48 hours and over 6 months can have follow-up in 24-48 hours or receive antibiotic prescription to use in if not improved in 24-48h 

Infants 3-6 months or at any age with high fever, severe pain, symptoms for >48 hours, acute perforation of TM, or bilateral AOM under 2 y should be treated with antibiotics at diagnosis.

Canadian pediatric society practice point

TREKK AOM

Infection Prevention and Control

Routine Practices

Contact precautions

If drainage not contained by dressing

Empiric Antimicrobials

OR

OR

OR

*For patients who have not improved or failed therapy with Amoxicillin.

IgE mediated Penicillin Allergy

OR

Macrolides may result in inferior treatment efficacy compared to beta-lactam antimicrobials

Usual Duration

10 days if < 2 years or if severe disease, AOM with perforation.

5 days if > 2 years and mild or moderate disease, uncomplicated.