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OTITIS MEDIA - ACUTE
Otitis media is a general term used to describe inflammation of the middle ear which may be caused by an acute infection.
The symptoms are usually nonspecific and include otalgia (pulling of ear in an infant), irritability, otorrhea with or without fever.
Symptoms of upper respiratory tract infection may also be present.

Follow Up

  • Clinicians should determine appropriate follow-up
  • Follow-up exam of asymptomatic patients at the completion of treatment is not necessary
  • It is recommended that follow-up exam is done in 3-4 weeks or w/in the next 4-6 weeks
  • Middle ear effusion (MEE) can persist for up to 1 month in 50% of patients & up to 3 months in 10% of patients even if there is bacteriologic cure
    • Persistence of MEE is not an indication for continued treatment or for another course of antibiotics
  • Hearing test should be performed if effusion is present 3 months post acute otitis media (AOM)
    • Refer to otolaryngologist if hearing loss persists

Expert Referral

Consider expert referral if any of the following occurs:

  • If no response to 2nd-line agents
    • Tympanocentesis w/ Gram stain & culture is recommended
  • Otitis media w/ effusion (OME) for ≥3 months w/ bilateral hearing loss ≥20 dB
  • ≥3 episodes in 6 months, ≥4 episodes in 12 months
  • Retracted tympanic membrane
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