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To the Editor.— The articles by Dr Paradise¹ and Drs Culpepper and Froom² were thought-provoking but both miss an important point well known to those of us "in the trenches" seeing children every day with a diagnosis of otitis. That is, otitis media (OM) has several different presentations in children, different enough to almost make one consider them different diseases. The categories are as follows: (1) the older child with upper respiratory infection (URI) symptoms for a few days, who develops severe ear pain in the evening or night, but is free of pain the next morning, with gross pus behind the tympanic membrane; (2) the very young infant (younger than 3 months) who presents with cold symptoms, slight fussiness, and thick fluid behind the tympanic membrane; (3) the child with URI symptoms, who develops severe toxic effects and high fever and looks very ill with acute otitis media (AOM); . . . [Full Text of this Article]

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Short-Course Antimicrobial Treatment for Acute Otitis Media: Not Best for Infants and Young Children
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ABSTRACT