Society guideline links: Acute otitis media, otitis media with effusion, and external otitis

Introduction — 

This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.

The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.

Links to related guidelines are provided separately. (See "Society guideline links: Pneumococcal vaccination".)

Canada

●Canadian Paediatric Society (CPS): Position statement for management of acute otitis media in children six months of age and older (2016, reaffirmed 2024)

●Choosing Wisely Canada: Don't place tympanvostomy tubes in most children for a single episode of uncomplicated otitis media with effusion of less than 3 months' duration (2024)

●Choosing Wisely Canada: Don't prescribe oral antibiotics for children with uncomplicated tympanostomy tube otorrhea or uncomplicated acute otitis externa (2024)

●Choosing Wisely Canada: Don't routinely prescribe intranasal/systemic steroids, antihistamines or decongestants for children with uncomplicated otitis media with effusion (2024)

●Choosing Wisely Canada: Don't use antibiotics in adults and children with uncomplicated acute otitis media (2021)

United States

●American Academy of Pediatrics (AAP): Policy statement on cochlear implants in children – Surgical site infections and prevention and treatment of acute otitis media and meningitis (2010, reaffirmed 2024)

●AAP: Red Book – Infection-prone body sites: Acute otitis media (2024)

●AAP: Red Book – Streptococcus pneumoniae (pneumococcal) infections: Acute otitis media (2024)

●AAP: Red Book – "Swimmer's ear"/acute otitis externa (2024)

●American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS): Clinical practice guideline on tympanostomy tubes in children, update (2022)

●AAO-HNS: Clinical practice guideline on otitis media with effusion, update (2016)

●AAO-HNS: Clinical practice guideline on acute otitis externa, update (2014)

●AAP: Clinical practice guideline for diagnosis and management of acute otitis media (2013)

Europe

●European Society of Head and Neck Radiology (ESHNR): European Society of Radiology (ESR) Essentials – Imaging of middle ear cholesteatoma: Practice recommendations (2025)

United Kingdom

●National Institute for Health and Care Excellence (NICE): Guideline on otitis media with effusion in under 12s (2023)

●NICE: Guideline on otitis media (acute) – Antimicrobial prescribing (2018, updated 2022)

Australia–New Zealand

●Choosing Wisely Australia: Don't prescribe oral antibiotics for uncomplicated acute otitis externa (2017)

●Choosing Wisely Australia: Don't treat otitis media (middle ear infection) with antibiotics, in non-Indigenous children aged 2-12 years, where reassessment is a reasonable option (2016)

Japan

●[In English] Japan Otological Society (JOS) and Oto-Rhino-Laryngeal Society of Japan: Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan, 2022 update (published 2023)

●[In Japanese] JOS and Japan Society for Pediatric ORL (JSPO): Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan (2022)

●[In English] JOS, Japan Society for Infection and Aerosol in Otorhinolaryngology (JSIAO), and JSPO: Clinical practice guidelines for the diagnosis and management of acute otitis media in children, 2018 update (published 2020)

●[In Japanese] JOS, JSPO, JSIAO: Clinical practice guidelines for the diagnosis and management of acute otitis media in children in Japan (2018)