Acute Otitis Media (AOM) remains one of the most frequent pediatric infections, often prompting early antibiotic use. An Italian intersociety consensus (2025), based on systematic review and Delphi methodology, re-examined evidence from 2012–2024 and adapted guidance from NICE (2022) and SIP (2019). The panel emphasized prudent antibiotic use: amoxicillin (90 mg/kg/day) as the preferred first-line, with initiation recommended only after 48–72 hours of watchful waiting in otherwise healthy children.
Amoxicillin-clavulanate or cephalosporins are reserved for children with risk factors such as immune deficiency, incomplete vaccination, or underlying conditions. Key updates include a five-day therapy duration and preference for narrow-spectrum molecules, aligning with stewardship principles. While amoxicillin-clavulanate is often chosen empirically, evidence for its superiority outside…
