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Tympanostomy tubes as effective as medical management in acute otitis media. Placement of tympanostomy tubes, the most frequently performed surgery in children, is no more effective than medical management in preventing recurrent acute otitis media (AOM), according to results of a recent study in the May 13 New England Journal of Medicine. In this study, 250 children six to 35 months of age with recurrent AOM were randomized to either undergo tympanostomy tube placement or medical management with amoxicillin-clavulanate or ceftriaxone for episodes of AOM. There were no significant differences between the groups in the rate of recurrence of AOM over two years. The children with tubes did have a longer time before the first episode of AOM, but the children in the medical management group had fewer cumulative days of otorrhea. Notably, there was no evidence of increased antimicrobial resistance in the children receiving antibiotics.