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Abstract

Acute otitis media (AOM) is a leading pediatric complaint and a major driver of antibiotic prescriptions. Current guidelines recommend analgesics and observation for mild to moderate cases, yet their use is poorly described. This retrospective review of 600 charts (ages 6 months–12 years) examined predictors of analgesic/antipyretic (A/A) recommendations and observation. A/A use was higher in the pediatric emergency department than ambulatory clinics (86.7% vs. 60.7%, p<0.001). Observation was recommended in 37.8% of visits and associated with absence of fussiness, fever, and tympanic membrane bulging. Findings identify key predictors for guideline-based management of AOM.

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