Treatments for otalgia in AOM.

Acetaminophen, ibuprofen

• ^{readily available, mainstay of pain management for AOM}
• ^{Effective analgesia for mild to moderate pain}

^{Home remedies (no controlled studies that directly address effectiveness)}

• ^Distraction
• ^{External application of heat or cold}
• ^Oil. 
• ^{May have limited effectiveness}

^{Topical agents}

• ^{Benzocaine (Auralgan, Americaine Otic). Additional but brief benefit over acetaminophen in patients >5 y}
• ^{Naturopathic agents (Otikon Otic Solution)-  Comparable with ametocaine/phenazone drops (Anaesthetic) in patients >6 y}

^{Homeopathic agents - No controlled studies that directly address pain}

^{Narcotic analgesia with codeine or analogs}

• ^{requires prescription; risk of respiratory depression, altered mental status, gastrointestinal upset, and constipation.}
• ^{Effective for moderate or severe pain}

^{Tympanostomy/myringotomy -  Requires skill and entails potential risk}

PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1451-1465