A single intramuscular dose of ceftriaxone is also as efficacious as 10 days of oral therapy. Antibiotics may be used for chemoprophylaxis of recurrent otitis in children. Myringotomy does not hasten recovery but is indicated for patients with intractable pain, progressive deafness, early mastoiditis, or poor responses to medical therapy. The prognosis for acute otitis media is excellent. Chronic serous otitis media, hearing loss, and recurrent purulent otitis media are the most common complications.
Acute mastoiditis develops in patients with inadequately treated otitis media.
Presenting symptoms consist of fever, otalgia, and postauricular edema and tenderness. Mastoid x-rays are usually abnormal. The species of bacteria responsible for mastoiditis are the same as those that cause acute otitis media. Patients who fail to respond to antibiotic therapy within 48 hours and those with CNS complications should be considered for early mastoidectomy. Other suppurative complications of acute otitis media are rare, including purulent labyrinthitis, meningitis, lateral sinus thrombosis, and brain abscess.