To Treat or Not to Treat with Antibiotics

Many question the need to treat otitis media with effusion, because the effusion will resolve in most children without active treatment in 2 or 3 months. Nevertheless, treatment may be indicated in some children, because there are possible complications and sequelae associated with this condition. Since hearing loss of some degree usually accompanies a middle ear effusion, treatment may be warranted when longstanding impairment in hearing is present. Although the significance of this hearing loss is still uncertain, such a loss may impair cognitive and language function and result in disturbances in psychosocial adjustment. Important factors that should be considered when deciding to treat or not to treat are listed in Table 78-5.

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