{"id":22863,"date":"2025-02-10T09:48:07","date_gmt":"2025-02-10T09:48:07","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=22863"},"modified":"2025-03-12T14:45:07","modified_gmt":"2025-03-12T14:45:07","slug":"recurrent-acute-otitis-media-raom","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatric-ent\/earinfectionsinchildren\/recurrent-acute-otitis-media-raom\/","title":{"rendered":"(Recurrent) Acute Otitis Media-(R)AOM"},"content":{"rendered":"\n<p>In young children aged under 2, who are not yet immunocompetent, recurrent ear infections (recurrent acute otitis media) are common and up to 6 episodes per year can be considered normal.<\/p>\n\n\n\n<p>This can in part due to the presence of <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatric-ent\/otitismediaeffusionpaeds\/\" target=\"_blank\" rel=\"noreferrer noopener\">Otitis Media Effusion (OME)<\/a> &#8211; Glue Ear.<\/p>\n\n\n\n<p>Other factors include recurrent URTI and teething.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-standard-black-color has-text-color has-link-color wp-elements-8a6f2e021464381127b7e023d33eb326\"><a><u>History<\/u><\/a>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Usually develops with \/ after an URTI on the background of OME.<\/li>\n\n\n\n<li>Symptoms: pain, discharge, fever, malaise<\/li>\n\n\n\n<li>Pain is a dull, deep-seated ache.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading has-standard-black-color has-text-color has-link-color wp-elements-3664931256b16e7e7a4107cc03ceff43\"><a><u>Examination<\/u><\/a>:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Otoscopy &#8211; drum red, bulging<\/li>\n\n\n\n<li>Can include discharging ear if tympanic membrane perforation (\u2018abscess draining\u2019).<\/li>\n<\/ul>\n\n\n\n<p>Please also see Primary Care Management.<\/p>\n\n\n\n<p><strong>C.M. &amp; G.T. 12\/02\/25<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<p>Refer urgently if complications (<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatrics\/paediatric-ent\/mastoiditispaeds\/\" target=\"_blank\" rel=\"noreferrer noopener\">mastoiditis<\/a>)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer:<\/strong><\/h4>\n\n\n\n<p>In young children (R)AOM is very common and <strong>less than 6 episodes in a year (or 4-5 in 6 months) do not constitute significant recurrence or need for intervention<\/strong>, unless the child is exceptionally unwell and adequate medical measures have failed.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Primary Care Management<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Supportive care (analgesia, antipyretics)<\/li>\n\n\n\n<li>If child &lt;2 and especially unwell consider antibiotics (usually amoxicillin)<\/li>\n\n\n\n<li>If ongoing ear discharge, topical ear drops &#8211; Ciprofloxacin with Betamethasone<\/li>\n\n\n\n<li>Prolonged course of antibiotics (usually amoxicillin, 1\/3 of daily dose for 3 months) if recurrent and troublesome but less than 6 episodes\/year. This can provide protection from infection until natural immunity has improved.<\/li>\n<\/ul>\n\n\n\n<p class=\"has-alert-red-color has-text-color has-link-color wp-elements-7503e0abf23cf0a566d992d026242ed5\">Refer urgently if complications (mastoiditis).<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>In young children aged under 2, who are not yet immunocompetent, recurrent ear infections (recurrent acute otitis media) are common and up to 6 episodes per year can be considered normal. This can in part due to the presence of Otitis Media Effusion (OME) &ndash; Glue Ear. Other factors include recurrent URTI and teething. History:<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":3889,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1225],"class_list":["post-22863","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-recurrent-acute-otitis-media-raom"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/entpaediatric\/earinfectionschildren\/https-apps-nhslothian-scot-refhelp-recurrent-acute-otitis-media-raom\/\" rel=\"tag\">(Recurrent) Acute Otitis Media-(R)AOM<\/a>","rttpg_excerpt":"In young children aged under 2, who are not yet immunocompetent, recurrent ear infections (recurrent acute otitis media) are common and up to 6 episodes per year can be considered normal. This can in part due to the presence of Otitis Media Effusion (OME) &ndash; Glue Ear. Other factors include recurrent URTI and teething. 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