Analgesics for pain

To relieve fever and pain, it is essential to use painkillers, with paracetamol (acetaminophen) as a priority. The use of an anti-inflammatory such as ibuprofen is also possible as an alternative after the age of 3 months.

Disinfect the nasal cavity

Disinfection of the nasal cavities with physiological serum or other solutions derived from seawater and / or nasal drops are essential, AOM always being linked to nasopharyngeal involvement.

Antibiotics if symptoms are moderate

Antibiotics have no interest in either serum-mucous otitis or congestive otitis. The majority of AOMs recover without antibiotics, so one can abstain from antibiotic treatment beyond two years of age if the signs (pain, fever) are moderate, and under monitoring of temperature and pain . Antibiotic therapy is indicated in children under two years of age, in cases of severe pain or fever over 39 ° C or if the pain or fever does not decrease after 24/48 H. 

The antibiotic prescribed is usually amoxicillin alone or the combination of amoxicillin / clavulanic acid in the form of tablets or oral solutions in the absence of allergy to penicillin.   

Ear drops

Instilling drops into the ear canal is of little use in acute otitis media, the infection being behind the eardrum. However, some can help reduce pain. Either way, it is much more important with AOM to put drops in the nose than in the ears!

Ear drops are on the other hand necessary when the eardrum is perforated, but only some can be used in this case, the others, potentially toxic for the ear being contraindicated in the event of perforation.

Paracentesis

Paracentesis, opening of the eardrum by a very thin blade, performed by the ENT under a microscope, remains interesting in very painful forms, with a very bulging eardrum and brings about the immediate disappearance of the pain.