Acute otitis media (AOM) is one of the most common infectious diseases in young children affecting approximately 80% of children by the age of 2 years and accounts for more than 40% of paediatric office visits.1 Another very common illness in children which often accompanies otitis media is an upper respiratory tract infection (URI) occurring six to eight times a year making it difficult to distinguish the coexistence of an AOM. Signs and symptoms of a URI cause significant distress to parents leading parents to suspect a diagnosis of an AOM in their children often insisting on antibiotics. Current guidelines from the American Academy of …