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The New Guidelines

Updated: Sep 26, 2022

A recent observation published by the American Academy of Pediatrics and the American Academy of Family Physicians advocates the “wait and watch” approach for all cases of earaches.



  • Each course of antibiotics given to a child can make future infections more difficult to treat. The result is an increase in the use of a larger range of – and generally more expensive – antibiotics. In addition, the benefit of antibiotics for Acute Otitis Media is small on average and must be balanced against potential harm of therapy.

  • About 15 percent of children who take antibiotics suffer from diarrhea or vomiting and up to 5 percent have allergic reactions, which can be serious or life threatening. The resistant bacteria in a child can be passed to siblings, other family members, neighbors, and pears in group-care or school settings.

  • The New Guidelines set by the American Academy of Pediatrics and the American Academy of Family Physicians provide an “option to observe for select children and only start antibiotic treatment if symptoms have not improved in 48-72 hours”.

  • Approximately 80 percent of children with Acute Otitis Media get better without antibiotics. And children whose ear infections are not treated immediately with antibiotics are not likely to develop a serious illness.

Source: American Academy of Pediatrics and the American Academy of Family Physicians Questions and Answers on Acute Otitis Media March 9,2004 http://www.aap.org/advocacy/releases/aomqa.htm [emphasis added]

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