Inclusion Criteria:
A child will be eligible for inclusion if he/she meets the following criteria:
- Age: ≥ 3 months and < 5 years at the time of enrolment. The subject becomes ineligible on the fifth birthday.
- Signs, symptoms, and conditions: i. One of the functional or general signs of otalgia (or its equivalent: irritability), conjunctivitis, fever AND EITHER ii. Paradise's criteria (bulging, diffused or localised inflamed tympanic membranes) OR iii. Spontaneous otorrhoea of less than 24 hours
- Onset of signs and symptoms of AOM within 72 hours prior to diagnosis of AOM by a physician. To be included as treatment failure, subjects must have then received antibiotic treatment from the physician, but remain symptomatic 48-72h after initiation of treatment
- Written informed consent obtained from parent or guardian prior to study start.
Exclusion Criteria:
The following criteria should be checked at the time of study entry. If any apply, the child must not be included in the study.
- Hospitalised during the diagnosis of AOM or during treatment,
- Otitis externa, or otitis media with effusion
- Presence of a transtympanic aerator
- Systemic antibiotic treatment received for a disease other than AOM in the 72 hours prior to enrolment,
- Receiving antimicrobial prophylaxis for recurrent AOM,
- Provision of antibiotic by paediatrician/ENT specialist at the enrolment visit, prior to the sampling
- Patients on antibiotics for AOM who are clinically improving.