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June 10, 1998

Controversies: Treatment of Acute Otitis Media—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(22):1783-1785. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-22-jac80008

In Reply.— Dr Harkness reminds readers that OM presents clinically in many forms. For the child in his category 1, I cannot agree with the recommendation to withhold antimicrobials. It is indeed likely, as Harkness suggests, that such a child would eventually recover without antimicrobial treatment, but it is less certain than if such treatment were given, and in any case, the risk of additional uncomfortable nights and additional sleep deprivation would be greater if antimicrobials were withheld. However, as I had commented, treatment for this older child could reasonably be limited to 5 days rather than the more customary 10 to 14 days.

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