Treatment

Treatments for ear infections cost the U.S. between 3 and 4 billion dollars each year, and many of these treatments, particularly heavy antibiotic use and surgical procedures, are often unnecessary in many children.

Experts continue to argue about the best approach for treating ear infections. The major debates rest on the use of antibiotics, surgery, and watchful waiting in both acute otitis media (AOM) and otitis media with effusion (OME).

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Watchful Waiting for AOM. Two studies published in 2005 evaluated the use and effectiveness of watchful waiting. In one study, 223 children with non-severe AOM were randomly prescribed either watchful waiting or immediate antibiotic treatment. The antibiotic group recovered more quickly, but had a high number of side effects and antibiotic-resistant bacterial strains. Parents were equally satisfied with either treatment approach, and two-thirds of children in the watchful waiting group recovered without needing antibiotics. A second study surveyed 2054 parents and 160 doctors on their use and perceptions of watchful waiting. Results indicated that although medical guidelines recommend watchful waiting, few doctors regularly practice it. Parents who had a higher educational level, more knowledge about antibiotics, and greater involvement in medical decisions were more likely to be satisfied with a watchful waiting recommendation.

Treatment Guidelines for Acute Otis Media (AOM) 

In 2004, the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) released updated guidelines for the management and diagnosis of acute otitis media.