Clinical Pathway for Evaluation/Treatment of Suspected
Acute Otitis Media in Children 2 Months to 12 Years
Suspected Acute Otitis Media (AOM)
Assess severity or presence of otorrhea from TM perforation
- Severe disease (any one of):
- Temperature ≥ 39°C (102.2°F) in past 48 hrs
- Moderate to severe ear pain
- Ear pain for ≥ 48 hours
Severe or otorrhea from TM perforation
Non-severe
< 6 mos
6-23 mos
≥ 2 yrs
Bilateral
Unilateral
Recommend 48-72 hrs observation
Consider safety-net antibiotic prescription (SNAP)
Durations by Age for SNAP
Antibiotic Recommendations| < 2 yrs | 10 days |
|---|---|
| 2-5 yrs | 7 days |
| ≥ 6 yrs | 5 days |
Posted: November 2008
Revised: March 2023
Authors: B. Ku, MD; G. Lawton, MD; S. Mittal, MD; L. Marlowe, MD; E. Huang, MD; L. Rodriguez, PharmD;
T. Metjian, PharmD; K. Chiotos, MD; J. Gerber, MD; R. Same, MD; J. Lavelle, MD
Revised: March 2023
Authors: B. Ku, MD; G. Lawton, MD; S. Mittal, MD; L. Marlowe, MD; E. Huang, MD; L. Rodriguez, PharmD;
T. Metjian, PharmD; K. Chiotos, MD; J. Gerber, MD; R. Same, MD; J. Lavelle, MD