The results of the 74 randomized, controlled studies of ear infections published between 1966 and 1999 were analyzed and reported in the August 2001 issue of Pediatrics. About 78% of children with acute otitis media (AOM) who do not receive antibiotics will recover without complications within a week. Of the 28% who did not get better, many would still have ear infections even if they did receive the antibiotics.
The benefit of antibiotics is small but real. About 8 children need to be treated for one child to have gotten better because of the antibiotics. The antibiotics do decrease pain in most kids, but there are gentler ways to do this.
Not all kids with ear infections need antibiotics. For children who appear well enough on my exam, I favor watchful waiting with pain control for 48 to 72 hours before starting antibiotics, if needed.