In general the natural course of Acute otitis media (AOM) is mild and the condition has a favourable outcome. The intervention of GPs can be limited to providing information and prescription of pain relief.
Antibiotic treatment is indicated in cases of severe or increasing illness or in the case of risk factors for complications.
Consider antibiotic treatment in those children who show no improvement after three days.
Consider antibiotic treatment in children with an episode of acute otitis media with otorrhoea at initial presentation and in children below the age of two with bilateral acute otitis media.