Clinical Practice Guidelines for the Diagnosis and Management of Acute Otitis Media (AOM) in Children in Japan - 2013 Update

Auris Nasus Larynx. 2015 Apr;42(2):99-106. doi: 10.1016/j.anl.2014.09.006. Epub 2014 Oct 18.


Objective: To (1) indicate methods of diagnosis and testing for childhood (<15 years) acute otitis media (AOM) and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of AOM in Children (Subcommittee of Clinical Practice Guideline), in light of the causative bacteria and their drug sensitivity of AOM in Japan.

Methods: We investigated the most recently detected bacteria causing childhood AOM in Japan as well as antibacterial sensitivity and the worldwide distinct progress of vaccination, produced Clinical Questions concerning the diagnosis, testing methods, and treatment of AOM, searched literature published during 2000-2004, and issued the 2006 Guidelines. In the 2009 and 2013 Guidelines, we performed the same investigation with the addition of literature, which were not included in the 2006 Guidelines and published during 2005-2008 and during 2009-2012, respectively.

Results: We categorized AOM as mild, moderate, or severe on the basis of tympanic membrane findings and clinical symptoms, and presented recommended treatment for each degree of severity.

Conclusion: Accurate assessment of tympanic membrane findings is important for judging the degree of severity and selecting a method of treatment. Some of new antimicrobial agents and pneumococcal vaccination are recommended as new treatment options.

Keywords: Acute otitis media (AOM); Antimicrobial agent; Multidrug-resistant bacteria; Recurrent otitis media (ROM); Treatment algorithm; Vaccination.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Diagnostic Techniques, Otological
  • Haemophilus Infections / diagnosis
  • Haemophilus Infections / drug therapy*
  • Humans
  • Infant
  • Japan
  • Otitis Media / diagnosis
  • Otitis Media / drug therapy*
  • Otitis Media / prevention & control
  • Otoscopy
  • Pneumococcal Infections / diagnosis
  • Pneumococcal Infections / drug therapy*
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / therapeutic use
  • Practice Guidelines as Topic*
  • Severity of Illness Index
  • Tympanic Membrane / pathology*


  • Anti-Bacterial Agents
  • Pneumococcal Vaccines