Acute otitis media is common in children, with approximately 1 in 4 having an episode in the first 10 years of life. It is particularly common in young children. In the USA infants average 1.2 and 1.1 episodes of acute otitis media in the first and second year of life, respectively, and it is the most common infection for which antibiotics are prescribed. Antibiotic use is currently less common in the UK.

Two clinical guidelines have recently been published, one from the Scottish Intercollegiate Guidelines Network (SIGN),¹ and the other from …