Clinical Practice and
Referral Guidelines

Otitis Media

According to the American Academy of Pediatricians and the American Academy of Family Physicians, “Acute otitis media is the most common infection for which antibacterial agents are prescribed for children in the United States. As such, the diagnosis and management of AOM has a significant impact on the health of children, cost of providing care, and overall use of antibacterial agents.”  The objective in developing this guideline was to provide the pediatrician with the tools to efficiently evaluate  these children in order to better diagnose, treat and make recommendations for referral to a pediatric otolaryngologist (ENT), when indicated.    

This guideline includes recommendations for:

  1. History and evaluation, which includes confirming acute onset, level of irritability, otorrhea and/or fever, signs of middle ear effusion (MEE), signs or symptoms of middle ear inflammation, level of child’s pain and the simultaneous appearance of purulent and erythematous conjunctivitis with AOM;
  2. Treatment, which may include, but not be limited to, observation, prescribed antibacterial agents and preventative education, and
  3. Referral to a pediatric ENT when indicated.

If you are a physician, and would like more information on the Clinical Practice and Referral Guideline for Acute and Chronic Otitis Media, please contact us at

If you are a parent and concerned about your child’s acute or chronic otitis media, please consult with your child’s pediatrician or primary care physician.

This guideline was developed from the American Academy of Pediatrics and the American Academy of Family Physicians, Clinical and Practice Guidelines for the Diagnosis and Management of Acute Otitis Media. Volume 113. No.5. May, 2000. Pp.1451-1465.

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