Since the recommendation came out last year I have been trying to NOT treat anyone over 2 with oral abx if they have a noncomplicated OM. I give the parents the speech regarding the current thought that most will resolve on their own and that our goal is pain control, and give them the auralgan drops and a promise that if they are not better in 48 hours I will see them again to revaluate. Well, in my office I haven't had much success with the no treatment approach. Most have had to come back and be put on abx, so many in fact that I now just write the rx for the abx and tell them to start the abx on their own in 48 hours if they are still not better because I can't fit all these kids back in my schedule and they could have started the abx that day anyway. I personally don't know why I have not been able to duplicate the results of the study. It might be because I have a very high threshold for calling a ear an OM in the first place (it must be so fluid filled and bulging with pain before I count it) that maybe the ones that I let go anyway (the dull or red ear, or small layered fluid not bulging, or even the infected ear without pain) were the ones they counted as OM that resolved. The drug reps hate me because I have the lowest doses of abx used per patient load in my area and 95% of it is plain old amoxil. I am really a pusher of the "it's viral, just wait and see" approach. Anyone else with similar results? Dianna Tolen, M.D. Kids First Pediatric Care Canfield, Ohio