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Management of Acute Otitis Media: Update

Management of Acute Otitis Media: Update

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US)

Version: November 2010

Executive Summary

Acute Otitis Media (AOM) 1 A diagnosis of AOM requires 1) a history of acute onset of signs and symptoms, 2) the presence of middle ear effusion (MEE), and 3) signs and symptoms of middle-ear inflammation. (Marcy, Takata, Shekelle, et al., 2001). is a viral and/or bacterial infection of the middle ear and represents the most common childhood infection for which antibiotics are prescribed in the United States. Timely and accurate diagnosis and management of AOM can have significant individual and public health consequences.


This chapter presents the results of the literature searches, reviews of pertinent systematic reviews, the accepted key questions, and the findings and analyses for each key question.


Our literature search procedures were extensive and included canvassing experts from academia, the clinical arena, and the FDA MedWatch database for studies. However, it is possible that other unpublished trial results exist for the treatments included in our report. Publication bias may occur, resulting in an overestimation of the efficacy of these treatments. In a few instances, we detected statistical evidence of possible publication bias (these instances are noted in the text).


The American Academy of Pediatrics requested that AHRQ commission an update of the 2001 evidence review, Management of Acute Otitis Media. AHRQ provided an initial list of questions.

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