TY - JOUR T1 - Update on acute otitis media in children younger than 2 years of age JF - Canadian Family Physician JO - Can Fam Physician SP - 1283 LP - 1285 VL - 57 IS - 11 AU - Colin J. McWilliams AU - Ran D. Goldman Y1 - 2011/11/01 UR - http://www.cfp.ca/content/57/11/1283.abstract N2 - Question As concern about antimicrobial resistance grows, I am aware of the need to reduce unnecessary antibiotic treatment; however, in my practice I see many children with acute otitis media (AOM) and this is the most common reason I prescribe antibiotics. Most of these children are young and otherwise healthy, and I am uncertain about when to prescribe antibiotics and when to endorse “watchful waiting.” Which children will benefit from antibiotic treatment? Answer Current Canadian guidelines recommend all children younger than 2 years of age with otalgia due to AOM and fever greater than 39°C be considered for treatment with amoxicillin. Watchful waiting is indicated only for children older than 6 months with mild-to-moderate AOM. Recent evidence suggests young children with a definitive diagnosis of AOM will benefit from antibiotics and experience fewer treatment failures compared with placebo, regardless of the severity of otitis. These studies do not challenge watchful waiting directly, and determining which children will improve spontaneously remains an enigma. ER -