Key Action Statements

Document Overview

Design and created by Guideline Central in participation with the American Academy of Pediatrics.

Diagnosis and Management of Acute Otitis Media

American Academy of Pediatrics

Publication Date: May 1, 2013

Page Last Updated: May 5, 2026

American Academy of Pediatrics Grading System

Level	Aggregate Evidence Quality	Benefit or Harm Predominates	Benefit or Harm Balanced
A	Intervention: Well-designed and conducted trials, meta-analyses on applicable populations Diagnosis: Independent gold standard studies of applicable populations	Strong Recommendation	Weak Recommendation (based on balance of benefit and harm)
B	≥1 RCTs Systematic reviews or meta-analyses of moderate-quality RCTs	Moderate
C	Nonrandomized trials, observational or registry studies, systematic reviews or meta-analyses of moderate quality studies	Moderate
D	Observational or registry studies with limited design and execution, systematic reviews or meta-analyses of studies limited by design and execution	Weak Recommendation (based on low quality evidence)	No recommendation may be made
E	Expert opinion, case reports, reasoning from first principles	Strong or Moderate Recommendation

Document Overview

Document Title: Diagnosis and Management of Acute Otitis Media

Authoring Society: American Academy of Pediatrics

Document Publication Date: May 1, 2013

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: pediatrics.aappublications.org/content/131/3/e964.full

Source Citation: Allan S. Lieberfall, et al. The Diagnosis and Management of Acute Otitis Media. Pediatrics. 2013; 131 (3) e964-e999.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Diagnosis, Management, Prevention, Treatment

Keywords: acute otitis media, breast feeding, immunization, otitis media, otitis media with effusion, otoscopy, tympanostomy tubes

Inclusion Criteria: Adolescent, Child, Infant

Health Care Settings: Ambulatory, Emergency Care, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 275

Literature Search Start Date: Monday, June 1, 2009

Literature Search End Date: Saturday, October 1, 2011

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: No

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes