Acute Otitis Media (AOM)

Further clinical guidance including interpretation of microbiology results available from:

CKS - acute Otitis Media scenarios guidance

NICE feverish children

Optimise analgesia and target antibiotics 

AOM resolves in 60% in 24hrs without antibiotics, which only reduce pain at 2 days (NNT15) and does not prevent deafness.

Consider 2 or 3-day delayed or immediate antibiotics for pain relief if:

<2 years AND bilateral AOM (NNT4) or bulging membrane or symptom score >8 for: fever; tugging ears; crying; irritability; difficulty sleeping; less playful; eating less (0 = no symptoms, 1 = a little, 2 = a lot)

All ages with otorrhoea NNT3.

Abx to prevent Mastoiditis NNT >4000.