Otitis Media: Therapy [Clinical Review Discussion]

Although there are serious concerns relating to the use of antibiotic drugs in the treatment of otitis media (OM), very little research has taken place to develop alternative, conservative treatments. Antedotal evidence and observational studies abound but few RCT’s were located to demonstrate effectiveness of drugless interventions.

The obvious first concern for the physician is to relieve pain and suffering of the patient as well as prevention of more serious pathological conditions. It is also important in OM to insure the patient does not experience hearing loss and suffer the associated sequelae of learning impairment and developmental delays in language and behavior.

Natural History: The reader should be aware when evaluating case series or case report designed studies the natural history of acute otitis media (AOM) is generally favorable. Sixty-one percent of cases resolve within 24 hours and 80% resolve within 3 days without treatment. Otitis media with effusion (OME) has a favorable response rate of 74% within 3 months without treatment (1).