In children with acute otitis media (AOM), when are antibiotics warranted and what is the appropriate duration of treatment?
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If the child is less than 6 months of age with a certain or uncertain diagnosis of AOM, treat with antibiotics. If the child is 6 months to 2 years of age with a certain diagnosis, treat with antibiotics; if the diagnosis is uncertain, observe if nonsevere illness. (SOR: B, based on limited-quality RCTs.) If the child is older than 2 years with a certain or uncertain diagnosis, observe if nonsevere illness. If antibiotics are indicated, the first-line choice is amoxicillin 80-90 mg/kg per day. (SOR: B, based on limited-quality RCTs.) Duration of treatment varies by the patient's age: if younger than 6 years or severe illness, treat for 10 days; if older than 6 years and nonsevere illness, treat for 5-7 days. (SOR: C, based on expert opinion.)
Evidence Based Practice 15(6): 06.