Otitis media with effusion (OME)

- Decongestants, antihistamines, corticosteroids, and antibiotics are NOT recommended in the treatment of OME.

- Up to 50% of children will have an effusion 1 month post AOM. Further antibiotic therapy not required. Up to 10% of children will have an effusion 3 months post AOM.

- Perform hearing test:

• in children with OME ≥ 3 months, or
• at any time, if speech or language delay, learning problems, significant hearing loss, or structural abnormalities of tympanic membrane,

and refer to ENT if hearing loss:

• hearing loss >20 dB: comprehensive audiologic evaluation.
• hearing loss >40 dB: comprehensive audiologic evaluation + ENT consult.

Duration of OME > 3 months and no hearing loss: Observation at 3-6 month intervals until resolution of effusion. No antibiotics.