Treatments for Otalgia in AOM

Acetaminophen, ibuprofen26Effective analgesia for mild to moderate pain, readily available, mainstay of pain management for AOM
Home remedies (no controlled studies that directly address effectiveness)May have limited effectiveness
 External application of heat or cold
Topical agents
 Benzocaine (Auralgan, Americaine Otic)27Additional but brief benefit over acetaminophen in patients >5 y
 Naturopathic agents (Otikon Otic Solution)28Comparable with ametocaine/phenazone drops (Anaesthetic) in patients >6 y
Homeopathic agents29,30No controlled studies that directly address pain
Narcotic analgesia with codeine or analogsEffective for moderate or severe pain; requires prescription; risk of respiratory depression, altered mental status, gastrointestinal upset, and constipation
Tympanostomy/myringotomy31Requires skill and entails potential risk