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Michael E. Pichichero, MD

JAMA. 1998;279:1748-1750.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Too often, acute otitis media (AOM) is overdiagnosed, and too often, unnecessarily long antibiotic therapies are prescribed. Faced with the challenge of increasing resistance among bacterial pathogens causing AOM,^1-2 an increased awareness that antibiotic treatment of AOM can provide important benefits to patients, but that spontaneous improvement also can occur,^3-4 and calls to curtail and more judiciously use antibiotics for this common clinical condition⁵ signal it is time for change.

The quality of scientific data to support a policy for shorter courses of antibiotic treatment of AOM has been comprehensively reviewed.⁶ In this issue of THE JOURNAL, Kozyrskyj et al⁷ present a meta-analysis that provides a systematic, quantitative evaluation of the evidence. The 32 comparative trials analyzed were divided into 3 groups according to the pharmacokinetic behavior of the antibiotic used: (1) oral short-acting antibiotics, eg, amoxicillin (clavulanate), cefaclor, cefuroxime, cefprozil, and cefpodoxime proxetil (n=17); (2) . . . [Full Text of this Article]

From the Department of Microbiology and Immunology, Elmwood Pediatric Group, University of Rochester Medical Center, Rochester, NY.

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