Observation Option Toolkit


Middle ear infection, or acute otitis media (AOM), is one of the most common reasons for children to visit their health care practitioner. It is also one of the most common reasons for prescribing antibiotics in children. Routine antibiotic prescriptions for all cases of otitis media have led to a 17-25% drug resistance rate for bacteria involved in middle ear infections in New York State. In an effort to correct this trend, the Department of Health reached out to the New York region’s leading clinical and public health practitioners and local health plans to consider evidence regarding changing concepts of diagnosis and management of AOM. As a result, the New York Region Otitis Project developed an international conference held in New York City in 2000. The Observation Option Toolkit for Acute Otitis Media evolved from that conference.

The Observation Option is commonly used in Holland, where only about 30% of children with AOM receive antibiotics, and the rate of drug resistant bacteria is 1%.The Observation Option refers to deferring antibiotic treatment of selected children for up to 72 hours. During this period, management is limited to analgesics and symptomatic relief. With appropriate follow up, complications are not increased and clinical outcomes compare favorably with routine initial antibiotic therapy. The Observation Option Toolkit presents evidence-based materials for the judicious use of the Observation Option. We encourage you to use the toolkit as an aid to help in the diagnostic and therapeutic management of acute otitis media, as well as an educational tool for the involved parent or caregiver in the management process. Please reproduce copies of these for your use.

  • Observation Option Toolkit for Acute Otitis Media - Out for Update