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For Otitis Media, Try Patience Before Drugs

Otitis media is an inflammation of the inner ear characterized by fluid buildup. The condition is one of the most common acute respiratory conditions managed in primary care, most frequently affecting children.

In fact, otitis media ranks second to the common cold as the most common health problem in children.

Despite its prevalence, treatment options for otitis media remain controversial. Most children are prescribed antibiotics, although considerable evidence suggests that the results are minimal at best. While antibiotics may have important benefits, there is little evidence suggesting that these prescriptions create positive differences in alleviating pain and distress associated with otitis media.

A study in the British Medical Journal investigated the utility of a 72-hour "wait-and-see" approach vs. antibiotics in managing otitis media in 315 children six months to 10 years of age. Children were randomly assigned to one of two protocols: antibiotics prescribed immediately, and prescriptions withheld for 72 hours. Results showed only minimal differences between the two groups, with no significant difference in school absence, pain or distress.

It's important to note that waiting for 72 hours while monitoring symptoms is safe, but a blanket approach of nonintervention may have dangers. However, these findings add to the considerable evidence espousing the value of conservative care in achieving positive health benefits. For more information on pediatric health, talk to your doctor and visit


Little P, Gould C, Williamson I, et al. Pragmatic randomized controlled trial of two prescribing strategies for childhood acute otitis media. British Medical Journal February 2001:322, pp336-342.