inflammation It may result from Eustachian tube dysfunction or represent the aftermath of resolved AOM, but is not an acute bacterial infection Patients with ear pain from AOM should receive analgesic treatment because antibiotics not generally provide symptomatic improvement for at least 24 hours Ibuprofen or acetaminophen are effective analgesic treatments of AOM Topical anesthetic–containing ear drops provide prompt, but short-lived pain relief Benzocaine-containing drops are no longer available in the United States because their safety has not been adequately studied and benzocaine can cause methemoglobinemia, especially in younger patients These oil-based preparations should not be administered if the TM has ruptured Narcotic analgesia can be used for very severe pain, but should rarely be necessary Efforts toward alternative approaches to pain management should be maximized first