Pain: Treat pain with analgesic eardrops or an over-the-counter medication such as acetaminophen.
Otitis media with effusion: Routine use of antihistamines, decongestants, and antibiotics is not recommended. Children should have a hearing test if OME lasts longer than 3 months or when there are suspected hearing, language, or learning problems.
Acute otitis media: Antibiotics are given to children younger than 6 months because these children have immature immune systems and are less able to fight infections. Between ages 6 months and 2 years, children may be given antibiotics depending on age, certainty of diagnosis, and severity of the infection. Children with nonsevere illness and an uncertain diagnosis may be watched for 48 to 72 hours without antibiotics. Most children do well, but if they do not improve in 48 to 72 hours, they may be given antibiotics.
Tympanostomy tubes are inserted when OME lasts longer than 3 months, there is recurrent AOM (3 episodes over 6 months or 4 in 1 year), or there is significant hearing loss.