Which kids with ear infections really do need antibiotics?

This is an important study.  Those of us who prefer not to use antibiotics routinely still struggle with concerns about which kids really would benefit.  In the study, kids with otitis media with a raised temperature and vomiting are more likely to benefit from immediate treatment with antibiotics than children with no fever or vomiting. These folks used data from a randomized controlled trial and identified predictors of poor outcome. Children who did not have raised temperature and vomiting were unlikely to have poor outcome and unlikely to benefit from immediate antibiotics.