Kenneth Grundfast, MD, Professor and Chairman of the Department of Otolaryngology–Head and Neck Surgery at Boston University School of Medicine, whole-heartedly agrees with this approach to antibiotic usage for AOM. He thinks that too many children may have received too much antibiotic for ear infections for too long. He even cites recent studies that call into question the long-held notion that persistent fluid in the ears of young children causes delays in speech development or impairs cognitive ability in children. He states, “Watchful waiting is a major step back toward a rational process—doing what’s best for the patient.”
It is important to note that advocates of the wait-and-see approach for prescribing antibiotics emphasize that the child should be treated symptomatically for the pain associated with AOM, typically with ibuprofen and otic analgesic drops.
The insertion of ventilation tubes for treatment of chronic and recurrent OME is surrounded by controversy regarding effectiveness and long-term sequelae. For decades, placement of ventilation tubes has been recommended by physicians and accepted by parents as necessary to avoid having children suffer lasting developmental abnormalities as a result of lingering fluid in the middle ear. Several studies, including the Pediatrics study by Roberts et al., mentioned earlier, have shown evidence that any developmental lags experienced by children who suffer from chronic or recurrent OME is temporary, and they soon catch up to their peers.