Duration of clinical symptoms in children under two years of age with acute otitis media

Objective: To describe the course of symptoms during the first ten days of episodes of AOM in children under two years of age. Methods: Within the framework of a placebo-controlled, double-blind, randomised trial studying the effect of amoxicillin on acute otitis media in children under two years of age in the Netherlands, symptoms were recorded in diaries by the parents. Durations of symptoms were plotted by means of Kaplan-Meier curves. Possible factors influencing the duration were analysed in a Cox regression. Results: Data from 230 children were used in the analyses. The median duration of fever was two days and the median duration of the combination of earache and/or crying was eight days. The duration of earache and/or crying was not influenced by any factor analysed (including treatment allocation). Conclusion: Fifty per cent of the children under two years with an episode of AOM had symptoms for more than eight days (95% CI: 6.9-9.1). Since antibiotic treatment did not influence this period, persistence of symptoms should not be a reason for changing antibiotic therapy.