The rocky road to rational prescribing.

Primary care physicians frequently see simple cases of acute otitis media (AOM), whilst specialists are generally presented with more complicated cases. Despite the high disease burden and high rates of consultation, diagnosis and management of AOM is currently suboptimal. Furthermore, problems with diagnosis and management have a direct impact upon worsening antibiotic resistance. This article discusses the unmet needs in AOM that need to be addressed in order to improve patient assessment and management. There is a need to further educate the public in order to 'demedicalize' this common disease. Effective vaccination is also an important component of optimal management.