Acute otitis media in children. Role of antibiotic therapy.

In a review and critical appraisal of the literature on antibiotic therapy for acute otitis media in children between 1939 and 1991, poor evidence supported the routine use of antibiotic therapy. Good evidence supported initial symptomatic treatment and institution of antibiotic therapy only in cases of an irregular course (fever or pain for more than 48 to 72 hours) in children 2 years and older. This approach cannot be recommended for children 2 years and younger because this age group has been excluded from most studies.