New recommendations for the management of acute otitis media in primary care

Jan-Harm Keijzer (1), Saphia Mokrane (1,2), Paul Van Royen (3), Nicole Dekker (1), Martine Goossens (1), Olivier Vanderveken (4), An De Sutter (5), Rupal Mehta (6), Cécile Ducène (7), Alexandra Sousa (8), Monique Boulad (9) Published in the journal : October 2023 Category : Médecine Générale

Summary :

This article is a summary of the recent update of the clinical practice guideline (CPG) on the management of acute otitis media (AOM) in general practice.

The CPG was developed with the participation of all relevant disciplines and according to an internationally recognized methodology for guideline development (Adapte procedure).

The elements of the medical history and clinical examination have limited diagnostic value and symptoms alone are not enough to make a diagnosis of AOM. The diagnostic hypothesis is based on the combination of these elements.

The doctor pays attention to the patient's experience and provides the necessary information to enable the patient to manage his/her disease properly (e.g., pain management, etc.). Shared decision making is a key point.

Antibiotics are justified in case of an unfavorable disease course and in the presence of major risk factors for complications. However, certain subgroups may benefit from antibiotic treatment.

Effective treatment (paracetamol or ibuprofen) of pain or fever has become the cornerstone of AOM management. More targeted antibiotic treatment is reserved for specific indications.


Otitis media, therapeutics, patient education, antibiotics, referral and consultation, preventive care