Guidelines for diagnosing and treating ear infections are changing and the result may mean fewer prescriptions for antibiotics.

The American Academy of Pediatrics released the new guidelines for diagnosing and managing acute otitis media (AOM), the most common form of ear infections.

It said pediatricians should only diagnose acute ear infections if the child's eardrum is moderately to severely bulging or if there is discharge leaking from the ear. They may diagnose a middle ear infection if the child's ear drum is mildly bulging and there is recent onset of pain or intense redness.

Doctors should only prescribe antibiotics in children 6 months and older if there are severe signs or symptoms, which the academy defines as a temperature of 102.2 degrees or higher, or severe pain or if young children between 6 and 23 months have ear infections in both ears.

"Studies have shown that bulging (of the eardrum) is the best criteria for diagnosing an ear infection." says Dr. Allan Lieberthal, lead author of the guidelines and clinical professor of pediatrics at the Keck School of Medicine at the University of Southern California.

If a toddler or baby (older than 6 months) has an ear infection in only one ear, then antibiotics should be an option as well as simply watching the child to see if things clear up on their own. If observation is chosen and the child not better within 72 hours, then it's time to consider antibiotics again, experts say.

The key message is that parents should not be expecting antibiotics each time, Lieberthal says.

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