Acute Otitis Media (AOM)
Optimise analgesia and target antibiotics AOM resolves in 60% in 24hrs without antibiotics, they only reduce pain at 2 days (NNT15) and do not prevent deafness. Antibiotics to prevent Mastoiditis NNT >4000
Consider 2 or 3-day delayed or immediate antibiotics for pain relief if:
<2 years AND bilateral AOM (NNT4) or bulging membrane and ≥ 4 marked symptoms.
All ages with otorrhoea (NNT3).
Penicillin Allergy: erythromycin