why use antibiotics with children with otitis media ?

I have been told that pediatricians now state that most cases of otitis media in children are viral in origin and do not require antibiotic treatment. If this is true, what treatment do you recommend? Watch and wait? Does the same approach apply to adults?—JOSEPH CAMIRE, DO, West Plains, Mo.

You have been told correctly. In 2004, the American Academy of Pediatrics and the American Academy of Family Physicians published joint clinical practice guidelines for the diagnosis and management of acute otitis media. The recommended treatment for children older than age two years is pain management and observation (unless the patient is severely ill). Such oral analgesics as acetaminophen or ibuprofen are most effective. A topical anesthetic

The National Institute for Health and Clinical Excellence (NICE), the NHS drugs rationing body, has issued the new guidance in which doctors are prohibited from prescribing antibiotics for minor illnesses such as an ear infection, sore throat, tonsillitis, a cold, sinus infection, cough or bronchitis.

In the guidance it is said that doctors should consider giving antibiotics to children under the age of two who have an ear infection in both ears, children who have discharge from the ears and those patients who have tonsillitis apart from other problems.