Antibiotic therapy for children with acute otitis media.

Question Acute otitis media is one of the most common infections in childhood. Routine prescription of antibiotics has led to adverse events and bacterial resistance to antibiotics. I have heard that "watchful waiting" is a good strategy to reduce this potential problem in children older than 6 months of age. Should I apply this strategy in my clinical practice? Answer Watchful waiting can be applied in selected children with nonsevere acute otitis media by withholding antibiotics and observing the child for clinical improvement. Antibiotics should be promptly provided if the child's infection worsens or fails to improve within 24 to 48 hours. Guidelines and most ongoing studies support these recommendations. Correct choice of regimen, dose, frequency, and length of treatment are all important.