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Painful middle ear infections, or acute otitis media (AOM), are the most common type of bacterial illness in U.S. children and the one most commonly treated with antibiotics. This has prompted calls in recent years for more judicious use of these drugs, due to concerns about resistance to antibiotics, says Dr. Lisa Rood, a pediatrician at John Muir Health Outpatient Center, Brentwood. “We’re not saying we don’t want to treat all ear infections,” Rood explains. “We want to treat the ones that need to be treated and not overtreat.”

If your child has symptoms of a middle ear infection, be aware that the American Academy of Pediatrics and the American Academy of Family Physicians advise doctors to:

  • Confirm AOM diagnosis and differentiate it from middle ear fluid, which requires different treatment.
  • Relieve pain, especially in the first 24 hours, with acetaminophen or ibuprofen.
  • Give parents, in some cases, the option of seeing if the infection will resolve on its own for 48 to 72 hours, then start antibiotics if symptoms don't improve. (For otherwise healthy children without underlying conditions that may alter the natural course of AOM.)
  • Prescribe amoxicillin for most children if antibiotic treatment is agreed upon.