Acute Otitis Media (AOM)

Acute Otitis Media (child doses)

Acute Otitis Media CKS

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.


Child doses
Neonate 7-28 days 30mg/kg TDS
1 month-1 yr: 125mg TDS
1-4 years: 250mg TDS
5-18 years: 500mg TDS

5 days

Penicillin Allergy: erythromycin

<2 years 125mg QDS

2-8 years 250mg QDS

8-18 years 250-500mg QDS

5 Days