Acute Otitis Media (AOM), inflammation or infection of the middle ear, is an illness most parents have had experience with. Countless hours of lost sleep and worry secondary to their child’s pain and distress can keep even the most seasoned parents awake at night. Before the age of 36 months, 83% of children will experience 1 or more ear infections and AOM is the most common reason for office visits of preschoolers in the United States (Zhou, Shefer, Kong & Nuorti, 2008). The graphic below serves as a review of evidence and explores the usefulness of the information in relation to the option of watchful waiting in the management of AOM.
Review of Evidence
Evidence to Evaluate Type of Source
General information, filtered, or unfiltered Appropriate or inappropriate
Type of Research
Primary research evidence, evidence summary, evidence-based guideline, or none of these
American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guideline: Diagnosis and Management of Acute Oitis Media Filtered Yes: Clinical practice guideline, with an evidence report, from a comprehensive review of evidence based literature on AOM completed by a committee of primary care physicians, and field experts.
Comprehensive peer review of this practice guideline was made before formal approval by partnering organizations.
This practice guideline specifically addresses watchful waiting regarding management of AOM. Evidence Based Guideline
Causative Pathogens, Antibiotic Resistance and Therapeutic Considerations in Acute Otitis Media
Pediatric Infectious Disease Journal Unfiltered No: A discussion and review of the evidence of isolated bacterial pathogens in patients with AOM. Specifically, middle ear fluid antibiotic concentrations.
Although interesting, this information is only of use concerning prescribing antibiotics and is not useful in regard to the use of watchful waiting in management of AOM. Evidence Summary
(Kelley, Friedman & Johnson, 2007)
Current Pediatric Diagnosis and Treatment
Ear, Nose and Throat General Information Yes: Useful, general referenced information from a pediatric medical book that discusses diagnosis and management of AOM. Reference to studies and data within the text.
Specific, useful discussion of watchful waiting as a treatment option. None of these. General information with references to data and studies within the book.
Treatment of Acute Otitis Media in an Era of Increasing Microbial Resistance
Pediatric Infectious Disease Journal Unfiltered Yes: Discussion and summary of evidence about studies on bacterial agents, antimicrobial resistance and considerations in selection of an antibiotic regimen.
While not specifically focused on watchful waiting, this article discusses studies and gives data on rates of spontaneous resolution of AOM without use of antibiotics. This is useful...