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Not all children need immediate antibiotics for AOM

Watchful waiting rather than giving immediate antibiotics is an appropriate approach to managing most children with mild acute otitis media (AOM), according to a meta-analysis published in the Lancet.

Antibiotics significantly reduced residual pain and/or fever at 3-7 days in children younger than 2 years old with bilateral AOM and in children with AOM and otorrhoea. However, antibiotics

were ineffective in older children

with mild disease.

Researchers carried out a

meta-analysis of data from six randomised trials on the effects of antibiotics in children with AOM, involving 1,643 children aged six

months to 12 years.


Rovers MM, Glasziou P, Appelman CL et al. Antibiotics for acute otitis media: a meta-analysis with individual patient data. Lancet 2006;368:1429–35

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