What is the first-line treatment for acute otitis media in children?

The first-line treatment for acute otitis media (AOM) in children is antibiotics, particularly amoxicillin. This is because AOM is primarily caused by bacterial infections, and amoxicillin is effective against the most common pathogens responsible for the condition, such as Streptococcus pneumoniae and Haemophilus influenzae.

Antibiotic therapy is recommended in cases where the child is diagnosed with AOM and exhibits moderate to severe symptoms, such as high fever, significant ear pain, or if the child is younger than six months old. Early intervention with antibiotics can help reduce complications associated with untreated bacterial infections, including resolving symptoms faster and reducing the risk of subsequent ear infections.

While observation can be a strategy in milder cases or in children older than two years with non-severe symptoms, it is not universal and is typically only considered in specific situations. Topical steroids and decongestants are not first-line treatments for AOM, as they are not effective against the underlying bacterial infection and do not address the primary symptoms associated with this condition.