Acute Otitis Media Clinical Pathway — All Settings | Children's Hospital of Philadelphia

Clinical Pathways Home Emergency ICU Inpatient Outpatient Specialty Care Primary Care

Goals and Metrics

Patient Education

Suspected Uncomplicated Acute Otitis Media (AOM)

Diagnostic Criteria

Considerations for Cochlear Implants

Assess severity or presence of otorrhea from TM perforation

Severe disease (any one of):
- Temperature ≥ 39°C (102.2°F) in past 48 hrs
- Moderate to severe ear pain
- Ear pain for ≥ 48 hours

Severe or otorrhea from TM perforation

Non-severe

< 6 mos

6-23 mos

≥ 2 yrs

Bilateral

Unilateral

Treat immediately

Durations by Age

Antibiotic Recommendations

Recommend 48-72 hrs observation

Consider safety-net antibiotic prescription (SNAP)

Durations by Age for SNAP

Antibiotic Recommendations

Antibiotic Durations by Age
< 2 yrs	10 days
2-5 yrs	7 days
≥ 6 yrs	5 days

Posted: November 2008
Last Revised: October 2024
Authors: B. Ku, MD; G. Lawton, MD; S. Mittal, MD; L. Marlowe, MD; E. Huang, MD; L. Rodriguez, PharmD;
T. Metjian, PharmD; K. Chiotos, MD; J. Gerber, MD; R. Same, MD; J. Lavelle, MD

Evidence

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact us.

©2024 by Children's Hospital of Philadelphia, all rights reserved.
Use of this site is subject to the Terms of Use.

The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

Clinical Pathway for Evaluation/Treatment of Suspected Uncomplicated Acute Otitis Media in Children 2 Months to 12 Years

Evidence

Clinical Pathway for Evaluation/Treatment of Suspected
Uncomplicated Acute Otitis Media in Children 2 Months to 12 Years