Acute Otitis Media-Watch and Wait Is Not a Myth

Acute otitis media is among the most common childhood infections and a major source of antibiotic use. Evidence from randomized trials shows that around 80% of cases resolve spontaneously, with antibiotics offering only modest symptomatic benefit and causing frequent adverse effects. Watchful waiting-with accurate diagnosis, effective analgesia, and clear safety-netting-achieves equivalent outcomes to immediate treatment in most children. Antibiotics remain essential for infants aged under 6 months, bilateral or suppurative disease, and high-risk groups. Aligning practice with evidence supports safer, more rational care and helps mitigate antimicrobial resistance.