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Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes.  They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.

Clinical Pathways: 

Inclusion and exclusion criteria:


    • 0 months to 18 years with:
      • Uncomplicated AOM
      • AOM with tympanostomy tubes
      • AOM with acute tympanic membrane perforation


    • <60 days with fever (defer to Febrile Infant Clinical Practice Guideline
    • Anatomic abnormalities (including cleft palate)
    • Genetic conditions with craniofacial abnormalities (such as Down Syndrome)
    • Immune deficiencies
    • Presence of cochlear implants

Committee members involved in the development:

  • Rana El Feghaly, MD, MSCI | Infectious Diseases | Committee Chair
  • Donna Wyly, MSN, RN, APRN, CPNP-AC, PCNP-BC, ONC | Urgent Care | Committee Member
  • Holly Austin, MD, FAAP | Urgent Care | Committee Member
  • Tanis Stewart, MSN, RN, FNP-BC, CPN | Emergency Medicine| Committee Member
  • Thomas Eyen, MD | Ear Nose and Throat (ENT) | Committee Member
  • Trisha Williams| Ear Nose and Throat | Committee Member

MIT Committee Members:

  • George Abraham, MD | Emergency Medicine, Medical Informatics
  • Tammy Frank, RPh, CPHIMS | Medical Informatics - Pharmacy
  • Tracy Taylor | Medical Informatics – ED, UCC

EBP Committee Members:

  • Kathleen Berg, MD, FAAP | Hospital Medicine, Evidence Based Practice
  • Jarrod Dusin, MS, RD, LD, CPHQ | Evidence Based Practice

Publication dates:

Finalized date: 10/2022

Next expected revision date: 10/2025

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These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.