NHS Dudley Health Economy Medicines Formulary
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12.1.2 Otitis media

General Guidance

  • Many cases are viral in origin and need treatment with simple analgesia only.
  • There is little evidence to support the use of antibiotics, even early use makes little difference to duration or severity or symptoms. However, despite this there may be a role for antibiotic therapy in children who are significantly distressed.
  • Local treatment of acute otitis media is ineffective and there is no place for drugs containing either a local anaesthetic or antibiotic.
  • There is little evidence to support the use of antihistamines or decongestants in acute otitis media.
  • Acute exacerbations of chronic infection may require systemic antibiotics (amoxycillin or erythromycin), treatment should be guided by swabs and culture results.

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary


Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

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