What is the first-line treatment for otitis media?

Amoxicillin is the first-line treatment for otitis media, particularly in cases caused by bacterial infections. This recommendation is based on its effectiveness against common pathogens like Streptococcus pneumoniae and Haemophilus influenzae, which are primary contributors to otitis media in children.

The use of amoxicillin is guided by its safety profile, dosage convenience, and the fact that most cases are self-limiting; however, when antibiotics are warranted due to severe symptoms or persistent infections, amoxicillin is typically the preferred choice.

Non-steroidal anti-inflammatory drugs like ibuprofen and acetaminophen can provide symptomatic relief from pain and fever but do not address the underlying bacterial infection. Azithromycin, while a viable antibiotic alternative for patients with penicillin allergies or when the first-line treatment fails, is generally not the first choice due to its broader spectrum and potential side effects, making amoxicillin the most effective initial treatment strategy for uncomplicated cases of otitis media.