 INTRODUCTION Acute Otitis Media AOM is the most common childhood infection for which antibiotics are prescribed.1-2 Several important factors have altered the prescription practices for AOM in the past decade. North America has seen an epidemic of microbial resistance, attributable in a large part to the over-prescription of antibiotics.3-4 Evidence has shown that AOM is commonly over diagnosed and antibiotics are prescribed unnecessarily.5-7 In addition a number of studies comparing antibiotic treatment to placebo, although proving superiority for antibiotic treatment, had very high rates of resolution with placebo. A meta analysis of 7 RCTs show a 73 success rate for Amoxicillin versus 60 for placebo.8 